A CASE OF NODULAR FASCIITIS OF THE PECTORALIS MAJOR MUSCLE FOLLOWING A LONG-TERM CLINICAL COURSE AND MASQUERADING BREAST CANCER

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  • 長期経過を辿り乳癌を疑わせた胸筋由来の結節性筋膜炎の１例

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Abstract

A 68-year-old woman had been aware of her poor breast development since she had been struck by a hard ball in the right anterior chest at 9 years old. She was seen at the hospital because local tenderness and deformity of the right breast appeared from 1 year earlier. At that time, an irregularly bordered, indurated mass with nipple truction was palpable in the right breast. Mammography and ultrasound findings suggested a category 4 abnormality and a malignant tumor, respectively. No qualitative diagnosis was made by core-needle biopsy. Since the clinical course and imaging findings could not rule out the possibility of breast cancer, we resected the right breast mass. The border between the mass and the pectoralis major muscle was unclear, and the resection of the mass was performed combined with partial muscle resection. The resected mass measured 7×7×3 cm in diameter. Histopathological examination showed immature fibroblasts growing in various directions, leading to the diagnosis of nodular fasciitis. The main location of the tumor suggested that it had arisen from the pectoralis muscle.<BR>Nodular fasciitis commonly arises from the extremities and rarely from the breast or pectoralis muscle. Compared with previously reported cases, her right breast tumor was characterized by following a long-term clinical course and having great diameters. We report this case because of its uncommon appearance and our difficulties in differentiating from breast cancer.

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