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OJHAS Vol. 10, Issue 2:
(Apr-Jun 2011) |
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| Hamartoma Breast, Chondromatous
Type |
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Vidya Bhat, Madhusmita
Jena, Department of Pathology, MVJ Medical College & Research
Hospital, Bangalore,
Santhosh KV, Department of Pathology, Vydehi Medical College
& Research Centre, Bangalore. |
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Address for Correspondence |
Assistant Professor,
Department of Pathology,
MVJ Medical
College & Research Hospital,
Dandupalya, Kolathur
Post,
Hoskote, Bangalore-562114,
Karnataka, India.
E-mail:
vidya.baliga.76@gmail.com |
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Bhat V, Jena M, Santhosh KV. Hamartoma Breast, Chondromatous
Type. Online J Health Allied Scs.
2011;10(2):27 |
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Submitted: May 8,
2011; Accepted: Jul 16, 2011; Published: Jul 30, 2011 |
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| Abstract: |
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This
case report describes an exceedingly rare case of hamartoma of breast
with predominantly chondroid stroma. A 45 year old lady presented with
a mobile lump in the upper outer quadrant of left breast, clinically
diagnosed as fibroadenoma. Mammography and FNAC were not done. She underwent
lumpectomy and we received the specimen measuring 7x5x3cm. Cut surface
of which revealed grey white nodule with glistening surface. Histopathologically
we found a circumscribed lesion with predominantly mature hyaline cartilage
separated by fibrocollagenous bands.
Key Words:
Cartilage;
Hamartoma
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Cartilage
is not uncommonly found in malignant mesenchymal and epithelial neoplasms
of human breast. However, the occurrence of cartilage in benign human
mammary tumors is extremely rare. We report a benign breast tumor with
islands of hyaline cartilage in a 45 years old woman.
A 45 years old female presented with a mobile lump in the
upper outer quadrant of left breast, clinically diagnosed as fibroadenoma.
The patient underwent lumpectomy. Fine needle aspiration and mammography
were not performed.
Gross: We received
a lumpectomy specimen measuring 7 x 5 x 3 cm. Cut section showed a well
defined grey white nodule measuring 4 x 2.8 cm, surrounded by fibrofatty
tissue. The surface depicted faintly glistening appearance.
Microscopy:
The breast tissue displayed a circumscribed lesion, containing lobules
of cartilaginous tissue separated by fibrocollagenous bands. The lobules
of cartilage contained closely arranged chondrocytes in lacunae, lacking
in any significant degree of atypia. The central portions of the lesion
exhibited ischemic necrosis. No mitoses were evident. At places, within
the islands of cartilage, cellular proliferation was seen, composed
of smaller possibly immature chondrocytes. Calcification was also noted.
No atypia of chondrocytes noted. No invasive growth pattern. Adipose
tissue lobules were seen at the periphery with lymphocytic infiltration. There
was no evidence of carcinomatous
component. The surrounding breast tissue was within normal limits. The lesion was diagnosed
as ‘Hamartoma breast – chondromatous type’.
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Fig.
1: Cartilaginous lobule with calcification (H&E, X 100) |
Fig. 2: Closely arranged chondrocytes in lacunae (H&E, X 400) |
Cartilage is rarely seen in benign conditions of human breast. Most
often, cartilaginous components are associated with a primary malignancy
of the breast.1 Cartilage is also encountered in the breast
as a component of benign chondrolipomatous tumor.1,2
The possible origins of cartilage in such tumors were discussed by Lugo
et al in 1982.3 They concluded that chondroplipomatous tumor
cannot be a part of hamartoma since it is not a normal component of
human breast and neither can be called a choristoma because of presence
of normal components like fat and breast ducts. They put forth the possibility
of dystrophic chondrification following traumatic fat necrosis. An alternate
explanation considered was metaplasia of the proliferating fibrous stroma
in fibrocystic breast disease. Smith and Taylor in 1969 reviewed 35
patients with mammary lesions that contained either metaplastic bone
and/or cartilage – none were chondrolipomatous.4 Nobuyuki
Uchida et al in 2004 presented a case of breast tumor with predominantly
chondromatous areas and lacking any fat and muscular tissue.5
This case was similar to our case where we found predominantly hyaline
cartilage surrounded by fibrocollagenous tissue, and no mammary ducts
and adipose tissue was seen within the tumor mass.
- Lugo M, Reyes JM,
Putong P. Benign Chondrolipomatous Tumors of the Breast. Arch Pathol
Lab Med. 1982;106:691-692.
- Sivakumar S, Kaur
G. Cytologic Features and Differential Diagnosis in Chondroma of the
Breast: A Case Report. Acta Cytol 2009;53:303-505.
- Kaplan L, Walts
AE. Benign Chondrolipomatous Tumor of the Human Female Breast. Arch Pathol Lab Med. 1977;101:149-151.
- Tse GMK, Law BKB,
Pang L-M, Chu WCW, Ma TKF, Cheung HS. Hamartoma of the Breast: a Clinicopathological
Review. J Clin Pathol. 2002;55:951-954.
- Uchida N, Shiojima
M, Sasamoto H, Ieta K, Inose T et al. A case of chondromatous tumor
of breast. Breast Cancer. 2004;11(2):206-209.
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