藤本 泰久, 東 雄三, 春次 智三郎, 妙中 直之, 吉井 友季子, 前川 仁, 加藤 保之, 曽和 融生

Yasuhisa FUJIMOTO, Yuzo HIGASHI, Tomosaburo HARUTSUGU, Tadayuki TAENAKA, Yukiko YOSHII, Hitoshi MAEKAWA, Yasuyuki KATO, Michio SOWA

大阪市立大学第1外科

The First Department of Surgery, Osaka City University Medical School

キーワード : Fatty necrosis of the breast, Breast cancer, Ultrasonography

A 81-year-old woman was admitted to the hospital because of a painless, index finger-sized tumor in the upper inner quadrant of her left breast. Ultrasonography showed hypoechoic irregular tumor echoes with a hyperechoic area in the surrounding subcutaneous layer of fat. Mammography showed a spiculated and ill-defined tumor, approximately 1.5 cm in diameter. We diagnosed the tumor as breast cancer, and performed a histological examination on a frozen section of fat necrosis in the breast under general anesthetic.
Partial glandectomy incorporating the tumor was carried out. Microscopic findings showed that the tumor consisted of many granulomatous nodulas with multinucleate giant cells.
Fat necrosis in the breast can present a hard mass similar to cancer in clinical findings and in a mammogram. Here preoperative diagnosis of this disease, especially that using ultrasonography, is discussed.