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      Breast Mucocele-like lesions (MLL): A case report and review of the literature

      case-report
      , MD * , , MD, PhD, , MD
      Radiology Case Reports
      Elsevier
      Mucocele-like lesions, Breast biopsies, High-risk

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          Abstract

          Mucocele-like lesions of the breast are rare, usually presenting themselves as suspicious findings on imaging, warranting biopsies. It can be associated with several degrees of hyperplasia, including atypical ductal hyperplasia and ductal carcinoma in situ, historically being considered a high-risk lesion. It also can be an underestimated invasive carcinoma in a percutaneous biopsy. When facing a histologic diagnosis of a mucocele-lesion in a percutaneous biopsy, it is important to be aware of these lesions' significance to make the most appropriate interpretation, recommendation, and management. The purpose of this work is to present some cases of breast mucocele-like lesions from our Institution and perform a review of the literature.

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          Most cited references17

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          Mucocele-like tumors of the breast.

          Ruptured cysts of the breast containing mucinous material may discharge secretions and epithelium into the surrounding tissues. This is a benign, little-known condition analogous to mucocele of the minor salivary glands. The age at diagnosis of six women with mucocele-like lesions (MLL) of the breast averaged 40 years (range, 25-61) and all but one were premenopausal. The lesion caused a mass in five cases. In one it was an incidental finding, and this patient had a separate unrelated nonmucinous intraductal carcinoma treated by mastectomy. One woman was treated by simple mastectomy. Four patients were treated by excision. All have remained well with follow-up of 6-88 months. The histological appearance of MLL of the breast simulates colloid carcinoma and should be considered in the differential diagnosis of such lesions. This is particularly important in young, premenopausal women, among whom colloid carcinoma is very uncommon. The contents of mammary MLL may be difficult to distinguish from colloid carcinoma in an aspiration biopsy.
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            Mucocele-like lesions diagnosed on breast core biopsy: assessment of upgrade rate and need for surgical excision.

            Mucocele-like lesion (MLL) is a rare mucinous lesion of the breast with highly variable upgrade rates to atypia or malignancy on excision. This spectrum of data has led to differing opinions on the need for surgical excision. We evaluated 50 core biopsy specimens diagnosed as having MLLs and correlated the findings with those of excision pathology. Thirty-eight patients underwent surgical excision and 29 were benign (76%), 4 had atypical ductal hyperplasia (11%), and 5 had ductal carcinoma in situ (13%), with an overall upgrade rate of 13%. However, the risk of upgrade was exclusively associated with the presence of atypia as seen on the needle core biopsy. All 22 MLLs without atypia had benign excisions, while 5 (31%) of the 16 patients with MLLs with atypia were upgraded to ductal carcinoma in situ on excision. No invasive carcinoma was identified. We believe it is reasonable that women with the core biopsy diagnosis of MLL without atypia and no associated mass be offered close clinical follow-up as an alternative to surgery.
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              Original report. Mucocele-like tumors of the breast: mammographic and sonographic appearances.

              The purpose of our study was to describe the mammographic and sonographic appearances of the mucocele-like tumor of the breast.
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                Author and article information

                Contributors
                Journal
                Radiol Case Rep
                Radiol Case Rep
                Radiology Case Reports
                Elsevier
                1930-0433
                28 December 2023
                March 2024
                28 December 2023
                : 19
                : 3
                : 1083-1089
                Affiliations
                [0001]Department of Radiology, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, IA 52242, USA
                Author notes
                [* ]Corresponding author. assim-saadeddin@ 123456uiowa.edu
                Article
                S1930-0433(23)00932-9
                10.1016/j.radcr.2023.12.017
                10789929
                38229604
                3bead361-f9ad-4786-ba6d-57adf16948f3
                © 2023 The Authors. Published by Elsevier Inc. on behalf of University of Washington.

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                : 6 November 2023
                : 9 December 2023
                Categories
                Case Report

                mucocele-like lesions,breast biopsies,high-risk
                mucocele-like lesions, breast biopsies, high-risk

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