An unusually large myofibroblastoma in a male breast: a case report

Abeywardana MS Abeysekara¹ , HP Priyantha Siriwardana¹ , K F Abbas¹ , Peter Tanner² and Akin A Ojo¹

¹Department of Surgery, King George Hospital, Barley Lane, Goodmayes, Essex IG3 8YB, UK

²Department of Pathology, King George Hospital, Barley Lane, Goodmayes, Essex IG3 8YB, UK

author email corresponding author email

Journal of Medical Case Reports 2008, 2:157doi:10.1186/1752-1947-2-157


Published:	14 May 2008

Abstract

Introduction

Myofibroblastoma of the breast is a rare benign stromal tumour seen predominantly in men. The gross appearance is that of a well-circumscribed nodule, characteristically small, seldom exceeding 3 cm. We present a case of an unusually large myofibroblastoma, which mimicked a malignant breast tumour.

Case presentation

A 65-year-old man presented with a rapid enlargement of the right breast over 6 weeks. Examination revealed a firm 15 cm hemispherical lump occupying the whole of the right breast with peau d'orange appearance of the overlying skin and distortion of the nipple. The clinical and radiological features suggested the possibility of sarcoma of the breast. However, a guided Tru-Cut biopsy was inconclusive. A mastectomy was performed to remove the tumour, which weighed more than 2 kg. Histopathology and immunocytochemistry revealed a mixed classical and collagenised type of myofibroblastoma. The patient is well with no evidence of recurrence 5 years after the mastectomy.

Conclusion

This unexpected presentation of an unusually large myofibroblastoma in a male breast is the largest reported to date. Myofibroblastomas can mimic malignant neoplasms and the clinical significance of this entity lies primarily in its recognition as a distinctive benign neoplasm.