0
February 01, 2007, Vol 142, No. 2 >
Special Feature | February 01, 2007

Image of the Month—Quiz Case FREE

Fernando Hernanz, MD; Pilar Alonso-Bartolomé, MD; Francisca Garijo, MD; Alfonso Vega, MD; Estrella Ortega, MD; Angel Alvarez, MD; Manuel Gómez-Fleitas, MD
Arch Surg. 2007;142(2):201. doi:10.1001/archsurg.142.2.201.
Text Size: A A A
Published online
Article
Figures
Comments
Figures in this Article

A 26-year-old white woman without risk factors for breast cancer had progressive enlargement of her left breast. There were no others symptoms. Physical examination revealed a large, painless, rubbery-firm, well-circumscribed, lobulated, mobile mass at the outer inferior quadrant of the left breast. There were no palpable axillary lymph nodes. Sonography showed a hypoechogenic mass with a 7.5-cm diameter, well-defined borders, and sporadic cyst areas in the periphery. Mammography showed an increased density at the inferior quadrants without calcifications (Figure 1). Core-needle biopsy revealed a benign feature: pseudoangiomatous stromal hyperplasia. Clinical follow-up was recommended. After 10 months, the patient experienced a significant increase in the size of the mass without other associated symptoms. Magnetic resonance imaging was performed. The images confirmed the presence of a well-encapsulated lesion measuring 11 cm in diameter. On T1-weighted imaging, the mass was isointense to the muscle with a homogeneous signal along the mass. On T2-weighted imaging, the mass was isointense to the mammary parenchyma. Contrast-enhanced, fat-suppressed fast-spoiled gradient-recalled echo images revealed a type II time-signal intensity curve and an intense ring-enhancing mass with large arteries and veins going to the mass (Figure 2). Surgical excision was indicated.

Place holder to copy figure label and caption
Figure 1.

Mammogram shows a dense mass without calcifications.

Grahic Jump Location
+Image not available.
View Large  |  Save Figure  |  Download Slide (.ppt)  |  View in Article Context
Image not available.

Place holder to copy figure label and caption
Figure 2.

Gadolinium contrast-enhanced image revealed an intense ring-enhancing mass with large arteries and veins going to the mass.

Grahic Jump Location
+Image not available.
View Large  |  Save Figure  |  Download Slide (.ppt)  |  View in Article Context
Image not available.

WHAT IS THE DIAGNOSIS?

A. Phyllodes tumor

B. Angiosarcoma

C. Hamartoma

D. Fibroadenoma

Figures

Place holder to copy figure label and caption
Figure 1.

Mammogram shows a dense mass without calcifications.

Grahic Jump Location
+Image not available.
View Large  |  Save Figure  |  Download Slide (.ppt)  |  View in Article Context
Image not available.
Place holder to copy figure label and caption
Figure 2.

Gadolinium contrast-enhanced image revealed an intense ring-enhancing mass with large arteries and veins going to the mass.

Grahic Jump Location
+Image not available.
View Large  |  Save Figure  |  Download Slide (.ppt)  |  View in Article Context
Image not available.

Tables

Interactive Graphics

Video

Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

References

Correspondence

Submit a Letter
CME
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Clear Answers | Save For Later
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s “Cited By” API will populate this tab (http://www.crossref.org/citedby.html).
Compression-Only CPR: Pushing the Science Forward
Cone
AAM 2010;304:1493-1495.
All you need to read in the other general journals
BMJ 2010;341:c5893-c1494.
Submit a Comment

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging & repositioning the boxes below.

See Also...
Special Feature
Image of the Month—Quiz Case
Arch Surg. 2007;142(2):201. doi:10.1001/archsurg.142.2.201.
Special Feature
Image of the Month—Diagnosis
Arch Surg. 2007;142(2):202. doi:10.1001/archsurg.142.2.202.
Articles Related By Topic
Image of the Month—Quiz Case
JAMA Surg. 2013;148(2):203. doi:10.1001/jamasurgery.2013.417a 10.1001/jamasurgery.2013.417b.
Image of the Month—Diagnosis
Arch Surg. 2012;147(10):976. doi:10.1001/archsurg.147.10.976.
Related Topics
PubMed Articles
Cardiac magnetic resonance in the differentiation of neoplastic and nonneoplastic pericardial effusion.
J Vet Intern Med 2011 Sep-Oct;;25(5):1003-9.
A large angiosarcoma of the right atrium: anaesthetic management.
Hellenic J Cardiol 2011 May-Jun;;52(3):273-7.
© 2013 American Medical Association. All Rights Reserved.
Powered bySilverchair Information Systems