Dr. Pepe’s Diploma Casebook: Case 38 – SOLVED!

Diploma_casebook_case38

Dear Friends,

This week I’m showing screening mammograms of a 39-year-old woman in whom an abnormality was found.

Diagnosis:
1. Radial scar
2. Carcinoma
3. Surgical scar
4. All of the above


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    12 Responses to : Dr. Pepe’s Diploma Casebook: Case 38 – SOLVED!

    1. Memento mei says:

      Radial scar in upper aouter quadrant

    2. Katerina says:

      In the upper-outer quadrant of the left breast there is a stellate lesion which is better seen in MLO view. In CC view the lesion would not be easily discernible if it didn’t produce a “tent sign”. The stellate lesion has no dark center and the spiculations are short(option 1 is ruled out). There is no skin thickening or suspicious microcalcifications. There are no enlarged lymphnodes in the left axilla.
      I choose 2.carcinoma

    3. gus says:

      i agree with katerina plus we have asymmetry in the central – internal quadrant in CC view in the R breast.
      we need compress view first und U/S in both lesions.
      mine first choose is 1.carcinoma but if i am wrong with the second lesion could be 4. All of the above

    4. Ricardo Macareno says:

      Until proven otherwise: carcinoma.

    5. Ayad says:

      I have same comment as Katerina, diagnosis 2carcinoma

    6. Ayad says:

      In the upper-outer quadrant of the left breast there is a stellate lesion which is better seen in MLO view. In CC view the lesion would not be easily discernible if it didn’t produce a “tent sign”. The stellate lesion has no dark center and the spiculations are short(option 1 is ruled out). There is no skin thickening or suspicious microcalcifications. There are no enlarged lymphnodes in the left axilla.

    7. genchi bari italia says:

      Non ho esperienza in senologia; tuttavia alcune considerazioni vanno fatte. Perchè uno “screening” mammografico già a 39 anni? C’è familiarità genetica per Cr: BR-CR1-BR-CR2? L’anamnesi è postiva per un precedente chirurgico,es. fibro-adenoma? la DD tra un radial-scar e un Cr si potrebbe fare con una RM con mdc paramagnetico, prima di un prelievo cito-istologico su guida US?L’esame clinico, parte “integrante” di una visita senologica, cosa ha trovato?

    8. Giovanni B. says:

      Distorsione dell’architettura ghiandolare: approfondimento! 1’ecografia. 2′ RM. 3’Biopsia.

    9. genchi bari italia says:

      caro dott.Pepe ed io cosa avevo detto circa l’RM con mdc come gold-standard per la diagnosi?

    10. genchi bari italia says:

      …di fronte al maestro…”chapeau”!

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