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Benign and Malignant Mucocele-Like Tumors of the Breast: Mammographic and Sonographic Appearances

¹ Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50, Ilwon-Dong, Kangnam-Ku, Seoul 135-710, South Korea.
² Present address: Department of Radiology, Sanggye Paik Hospital, Inje University College of Medicine, Seoul 139-707, South Korea.
³ Depatment of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 135-710, South Korea.

View larger version (147K): [in a new window]   Fig. 1A —41-year-old woman with benign mucocele-like tumor of breast. Screening mammogram shows pleomorphic microcalcifications in clustered distribution.

View larger version (118K): [in a new window]   Fig. 1B —41-year-old woman with benign mucocele-like tumor of breast. Sonogram shows cyst with calcified mural nodule.

View larger version (140K): [in a new window]   Fig. 1C —41-year-old woman with benign mucocele-like tumor of breast. Photomicrograph shows thick-walled cyst with mucin extruded into surrounding stroma. Calcifications are not evident due to loss during preparation.

View larger version (96K): [in a new window]   Fig. 2A —29-year-old woman with bilateral malignant mucocele-like tumor who presented with palpable mass in right breast. Bilateral mediolateral oblique mammogram shows pleomorphic calcifications mixed with large coarse eggshell-shaped calcifications in diffuse distribution extending over a wide area. Definite mass shadow is not seen.

View larger version (42K): [in a new window]   Fig. 2B —29-year-old woman with bilateral malignant mucocele-like tumor who presented with palpable mass in right breast. Photograph of surgical specimen shows multiple mucin-filled cysts. Bilateral mucocele-like tumor with ductal carcinoma in situ was confirmed at surgery.

View larger version (91K): [in a new window]   Fig. 3A —36-year-old asymptomatic woman with benign mucocele-like tumor and recurrence after removal of calcifications 7 months ago. Mammogram shows multiple separate round calcific clusters. Sonography (not shown) revealed only calcification without mass or cyst. Patient underwent excisional biopsy after needle localization for largest calcific cluster (arrows), and on postoperative mammography (not shown), cluster had disappeared.

View larger version (138K): [in a new window]   Fig. 3B —36-year-old asymptomatic woman with benign mucocele-like tumor and recurrence after removal of calcifications 7 months ago. Photomicrograph shows extravasated mucin with dense calcifications and mild ductal hyperplasia. (H and E, original magnification, x12.5)

View larger version (89K): [in a new window]   Fig. 3C —36-year-old asymptomatic woman with benign mucocele-like tumor and recurrence after removal of calcifications 7 months ago. Mammogram obtained 7 months after A and B shows new calcific clusters (arrow) have also developed in other region of same breast.

View larger version (162K): [in a new window]   Fig. 4 —55-year-old woman with benign mucocele-like tumor and known contralateral breast cancer. Screening mammogram shows pleomorphic calcifications with multiple clusters associated with well-defined nodular densities (arrows). Number of calcifications showed increasing pattern since previous screening mammogram (not shown).

View larger version (140K): [in a new window]   Fig. 5A —40-year-old woman with malignant mucocele-like tumor of left breast. Screening mammogram shows multiple pleomorphic calcific clusters with segmental distribution associated with multiple rosarylike masses (arrows).

View larger version (115K): [in a new window]   Fig. 5B —40-year-old woman with malignant mucocele-like tumor of left breast. Sonogram shows single small hypoechoic nodule with calcification.

View larger version (154K): [in a new window]   Fig. 5C —40-year-old woman with malignant mucocele-like tumor of left breast. Four photomicrographs from one specimen show mucin in cysts (left upper image), mucin extruded from cysts (right upper image), mucin with calcifications within lobules (left lower image), and mucinous carcinoma (right lower image), represented as floating carcinoma cells in mucin. Mucocele-like tumor with mucinous carcinoma is proven. (H and E, original magnification, x12.5, x40)

View larger version (94K): [in a new window]   Fig. 6A —44-year-old woman with malignant mucocele-like tumor who presented with palpable mass in right breast. Mammogram shows segmentally distributed pleomorphic microcalcifications with ill-defined increased opacity (arrows).

View larger version (105K): [in a new window]   Fig. 6B —44-year-old woman with malignant mucocele-like tumor who presented with palpable mass in right breast. Sonogram shows conglomerated multiple small cysts with internal calcifications (arrows).

View larger version (134K): [in a new window]   Fig. 6C —44-year-old woman with malignant mucocele-like tumor who presented with palpable mass in right breast. Photomicrographs show mucin-filled epithelium-lined cysts with extravasated mucin in stroma (left image) and micropapillary-type ductal carcinoma in situ associated with mucocele-like tumor (right image). (H and E, original magnification, x12.5, x40)

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