Concurrent invasive ductal carcinoma and ductal carcinoma in situ arising inside and outside a breast hamartoma: A case report

Figure 1 Mammography. A: Mammography revealed a circumscribed mass including fat and glands with suspicious local architectural distortion; B: Ultrasonography revealed a heterogeneous tumor with a smooth capsule (hamartoma; thin arrow) and an irregular, hypoechoictumor with posterior decrescence and an indistinct boundary (invasion; thick arrows); C: Computed tomography revealed a well-defined elliptical mass with uneven density; D: Magnetic resonance imaging showing the circumscribed mammary hamartomaswith dense fibroglandular tissue and fat (hamartoma; thin arrow). Note the marked irregular enhancement region with type 2 enhancement curves within hamartoma( thick arrows) , and the concerning area of architectural distortion with type 2 enhancement curves at the lower margin of the hamartoma (white dot arrows).

Figure 2 Pathology. A: Low power magnification [haematoxylin and eosin (HE) staining, 12.5 ×]: Mass including invasive ductal carcinoma and ductal carcinoma in situ inside was encapsulated by delicate fibrous tissue; B: Low power magnification (HE staining, 12.5 ×): Invasive ductal carcinoma and ductal carcinoma in situ involved normal breast tissue external to hamartoma; C: High power field of invasive ductal carcinoma lesion of Figure 2A (HE staining, 100 ×); D: High power field of ductal carcinoma in situ lesion of Figure 2A (HE staining, 100 ×); E: High power field of invasive ductal carcinoma lesion of Figure 2B (HE staining, 200 ×); F: High power field of ductal carcinoma in situ lesion of Figure 2B (HE staining, 200 ×).