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Ultraschall Med 2005; 26(1): 42-45
DOI: 10.1055/s-2004-813122
Case Report

© Georg Thieme Verlag KG Stuttgart · New York

Juvenile Papillomatosis (JP) of the Female Breast (Swiss Cheese Disease) - Role of Breast Ultrasonography

Juvenile Papillomatose (JP) der weiblichen Brust (Swiss Cheese disease) - Bedeutung der SonographieR. Ohlinger1 , G. Schwesinger3 , A. Schimming2 , G. Köhler1 , H. Frese1
  • 1Department of Gynecology and Obstetrics (Director: Prof. Dr. med. Dr. h. c. W. Straube), Ernst Moritz Arndt University of Greifswald
  • 2Department of diagnostic and interventional Radiology (Director: Prof. Dr. med. N. Hosten), Ernst Moritz Arndt University of Greifswald
  • 3Institute of Pathology (Director: Prof. Dr. med. G. Lorenz), Ernst Moritz Arndt University of Greifswald
Further Information

Publication History

received: 12.8.2003

accepted: 5.3.2004

Publication Date:
07 February 2005 (online)

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Zusammenfassung

Die juvenile Papillomatose ist eine sehr seltene benigne Brustdrüsenerkrankung. Beschrieben wird ein Fall einer 16-jährigen Patientin. Palpatorisch fand sich ein ca. 8 cm großer verschiebbarer Knoten. Sonographisch zeigte sich eine ovale, gut abgrenzbare, echoarme heterogene Läsion mit multiplen zystischen Foci. Klinisch und mammographisch ist die Vorhersage einer JP nicht möglich. Die Sonographie hingegen ist hilfreich und ermöglicht eine relativ gute Abgrenzung gegenüber einer einfachen Zyste, einem Fibroadenom, einem phylloiden Tumor oder einem intrazystischen Papillom und Karzinom. Die Diagnosesicherung sollte präoperativ über eine Stanzbiopsie erfolgen. Eine offene Biopsie mit Exzision im Gesunden wird aufgrund einer möglichen späteren Karzinomentstehung angeraten.

Abstract

This report summarises the imaging findings of juvenile papillomatosis (JP) in a 16-year-old woman. Sonographically, the lesion was oval, well defined, heterogeneous with multiple small, cystic spaces. Ultrasonography can be helpful in differentiating between JP and similar cystic lesions, fibroadenomas, phyllodes tumours, intracystic papillomas and carcinomas. A core needle biopsy is still needed to confirm the diagnosis. An open biopsy with excision of the lesion is mandatory, mere observation is inadequate because of insufficient knowledge about the direct relationship between JP and subsequent cancer.

Schlüsselwörter

Brust - Juvenile Papillomatose - Mammasonographie - Mammographie - MRT - Pathologie

Key words

Breast - juvenile papillomatosis - ultrasonography - mammography - magnetic resonance imaging - pathology

References

  • 1 Rosen P P, Contrell B, Mullen P D. et al . Juvenile papillomatosis (Swiss cheese disease) of the breast.  Am J Surg Pathol. 1980;  4 3-12
    CrossrefPubMedGoogle Scholar
  • 2 Bazzocchi F, Santini D, Martinelli G. et al . Juvenile papillomatosis of the breast. A clinical and pathologic study of 13 cases.  Am J Clin Pathol. 1986;  86 745-748
    PubMedGoogle Scholar
  • 3 Rosen P P, Holmes G, Lesser M L. et al . Juvenile papillomatosis and breast carcinoma.  Cancer. 1985;  55 1345-1352
    PubMedGoogle Scholar
  • 4 Rosen P P, Lyngholm B, Kinne D W. et al . Juvenile papillomatosis of the breast and family history of breast carcinoma.  Cancer. 1982;  49 2591-2595
    CrossrefPubMedGoogle Scholar
  • 5 Schulz H J, Guski H, Winzer K J. Intraductal juvenile papillomatosis of the breast.  Zentralbl Chir. 1987;  112 622-625
    PubMedGoogle Scholar
  • 6 Rosen P P, Kimmel M. Juvenile papillomatosis of the breast. A follow-up study of 41 patients having biopsies before 1979.  Am J Clin Pathol. 1990;  93 599-603
    PubMedGoogle Scholar
  • 7 Kiaer H W, Kiaer W W, Linell F. et al . Extreme duct papillomatosis of the juvenile breast.  Acta Pathol Microbiol Scand. 1979;  87A 353-359
    PubMedGoogle Scholar
  • 8 Pettinato G, Manivel J C, Kelly D R. et al . Lesions of the breast in children exclusive of typical fibroadenoma and gynecomastia. A clinicopathologic study of 113 cases.  Pathol Annu. 1989;  24 296-328
    PubMedGoogle Scholar
  • 9 Hidalgo F, Llano J M, Marhuenda A. Juvenile papillomatosis of the breast (Swiss cheese disease).  Am J Roentgenol. 1997;  169 912
    PubMedGoogle Scholar
  • 10 Tafurelli M, Santini D, Martinelli G. et al . Juvenile papillomatosis of the breast. A multidisciplinary study.  Pathol Annu. 1991;  26 25-35
    PubMedGoogle Scholar
  • 11 Talisman R, Nissim F, Rothstein H. et al . Juvenile papillomatosis of the breast.  Eur J Surg. 1993;  159 317-319
    PubMedGoogle Scholar
  • 12 Kersschot E, Hermans M E, Pauwels C. et al . Juvenile Papillomatosis of the breast: sonographic appearance.  Radiology. 1988;  169 631-633
    PubMedGoogle Scholar
  • 13 Farid M K, Sarma H N, Ramesh K. et al . Giant juvenile papillomatosis of the breast.  East Afr Md J. 1997;  74 116-117
    PubMedGoogle Scholar
  • 14 Mussurakis S, Carleton P J, Turnbull L W. Case report: MR imaging of juvenile papillomatosis of the breast.  Br J Radiol. 1996;  69 867-870
    CrossrefPubMedGoogle Scholar
  • 15 Fleischer A, Muhlethaler C, Reynolds V. et al . Palpable breast masses: evaluation by high-frequency, hand-held real-time sonography and xeromammography.  Radiology. 1984;  153 813-817
    PubMedGoogle Scholar
  • 16 Kopans D. What is a useful adjunct to mammography?.  Radiology. 1986;  161 560-561
    PubMedGoogle Scholar
  • 17 Sickles E, Filly R, Callen P. Benign breast lesions: ultrasound detection and diagnosis.  Radiology. 1984;  151 467-470
    PubMedGoogle Scholar
  • 18 Cole-Beuglet C, Soriano R, Kurtz A. et al . Ultrasound, x-ray-mammography and histopathology of cystosarcoma phylloides.  Radiology. 1983;  146 81-86
    PubMedGoogle Scholar
  • 19 Kersschot E, Hoste M, Dochez C. et al . Intracystic carcinoma of the breast.  Fortschr Röntgenstr. 1986;  144 728-729
    PubMedGoogle Scholar
  • 20 Reuter K, D’Orsi C, Reale F. Intracystic carcinoma of the breast: the role of ultrasonography.  Radiology. 1984;  153 233-234
    PubMedGoogle Scholar
  • 21 Han B K, Choe Y H, Ko Y H. et al . Benign papillary lesions of the breast: sonographic- pathologic correlations.  J Ultrasound Med. 1999;  18 217-223
    PubMedGoogle Scholar
  • 22 Ostrzega N. Fine needle aspiration cytology of juvenile papillomatosis of breast: a case report.  Diagn Cythopathol. 1993;  9 457-460
    PubMedGoogle Scholar
  • 23 Nonomura A, Kimura A, Mizukami Y. et al . Secretory carcinoma of the breast associated with juvenile papillomatosis in a 12-year-old girl. A case report.  Acta Cytol. 1995;  39 569-576
    PubMedGoogle Scholar

OA Dr. med. R. Ohlinger

Lt. Funktionsbereich Senologie/Brustzentrum, Ernst Moritz Arndt University of Greifswald, Department of Gynecology and Obstetrics

Wollweberstraße 1 - 3

17489 Greifswald

Germany

Phone: +49/38 34/86 65 10

Fax: +49/38 34/86 65 41

Email: ralf.ohlinger@uni-greifswald.de

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