Dr. Pepe’s Diploma Casebook: Case 29 – SOLVED


Dear Friends,

To finish the chapter on male breast disease I am showing mammograms with selected pathology in four different males with palpable retro-areolar lesions. Try to match each case (A-D) with the correct diagnosis.

1. Gynecomastia
2. Carcinoma
3. Epidermoid cyst
4. Simple cyst

Click here for the answer

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    21 Responses to : Dr. Pepe’s Diploma Casebook: Case 29 – SOLVED

    1. Ricardo Macareno says:

      3 corresponds to C and D: Epidermoid cysts occur in mammography as a density well-defined oval next to the skin in the area palpable. They have medium to high density, are well defined and without calcifications.

      1 and 2 correspond to Option A. Gynecomastia is the presence of fat tissue and fat tissue mamario.Pseudoginecomastia only.

      4 corresponds to option B

    2. Albert says:

      1A, 2D, 3C, 2D

    3. Albert says:

      1A, 2D, 3C, 4B

    4. Burak says:

      1a 2b 3c 4d

    5. Mihai Comsa says:

      1-A Flame apearence no calcifications (gynecomastia)
      2-D Iregular border, posible invasion of skin (carcinoma)
      3-C Fine border in contact with cutaneus tisue (epidermoid cyst)
      4-B Fine border localised in subcutaneus fat (simple cyst)

    6. Katerina says:

      1 – A Gynecomastia (dendritic type)
      2 – D Carcinoma (irregular border – high density)
      3 – C Epidermoid cyst (sharp borders – high density)
      4 – B Simple cyst (sharp borders- low density – hypodense halo surrounding the lesion)

    7. genchi bari italia says:

      A = 1 -ginecomastia tipo dendritico( aspetto del tutto simile agli US). B= 3 =cisti epidermoide( densità simil-adiposa) C =4 =cisti semplice ( omogeneamente altamente opaca ed a bordi netti) D= 2 =cr mammario( Bordi iregolari e con scomparsa del piani di clivaggio con il tessuto sottocutaneo) .

    8. genchi Bari Italia says:

      Errata corrige: B = cisti semplice(” indovata” nel tessuto mammario . dal quale è separata da sottile orletto rx-trasparente).C = cisti epidermoide( piu’ superficiale, a contatto con il piano cutaneo e con “impronta” sul tessuto ghiandolare sottostante).Invariate le restanti risposte: A = 1 e D = 2. Scusatemi.

    9. Dr.Pepe says:

      Before the answer is posted, I want to say that you all did well, although the answers may not be correct. Nowadays US examination is basic to interpret breast disease properly and you had only the mammograms.

      • burak says:

        Dr Pepe ,I think that you should thank to me .
        Because only I had done 4 for the correct answer .

        • Dr. Pepe says:

          Yes, you shuld be congatulated for making the right diagnosis of number 4. Still, you transposed numbers 1 and 2.
          Considering that you had only half of the information (no ultrasound), you did well.

    10. genchi bari italia says:

      Sono d’accordo che gli US , con l’ECO-color doppler e “l’elastosonografia” sono gli esami di base e “preliminari” ad una mammografia.Con questi esami preliminari, la diagnosi di cisti semplice, ginecomastia, Cr e cisti epidermoide è già fatta al 90/° , senza ricorrere alla stessa mammografia.Certo stiamo discutendo della semeiotica di “base” di una mammografia, traendone solo da essa una possibile diagnosi.

    11. Genchi bari italia says:

      Grazie dr Pepe: mi hai dato una “lezione” in tutti i sensi, dimostrando come alcuni dati semeiologici, alla mammografia possono essere confondenti!!!

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