Breast Hemangioma: A Diagnostic Dilemma

Abstract

Vascular tumours of breast are extremely rare and constitute more commonly of angiosarcomas and hemangiomas. Benign hemangiomas constitute 0.4% of all breast tumours. Due to lack of characteristics features, diagnosing them using conventional imaging techniques pre-operatively is very difficult. We present a case of a 14 year old female with complains of slow growing, painless mass of 1 year duration. She had no prior history of trauma or breast disease. On physical examination, no nipple discharge, axillary lymphadenopathy or contra lateral breast abnormality was noted. There was no family history of breast malignancy. Ultrasonography report stated soft tissue mass with increased vascularity and fine needle aspiration cytology had only hemorrhagic aspirate without any ductal cells. Due to the discordance of both the investigations and the patient's unwillingness to not to undergo further invasive investigations, excision of mass was done. On histopathological examination a 5X3X2 cm firm mass with oedematous, pale brown areas along with haemorrhagic areas were seen on cut-section. Microscopy confirmed the diagnosis of cavernous hemangioma. It is important to differentiate accurately benign hemangiomas from their malignant counterpart and also to rule out possibility of an underlying low grade malignancy. Accurate pre-operative diagnosis by ultrasonography and fine needle aspiration pose a great challenge, hence complete excisional biopsy of the lesion is recommended to resolve the clinical dilemma.

Keywords

• Cavernous Hemangioma
• Female Breast
• Vascular Tumour