25246819 Visualization

A 19 Age - year Age - old Age woman Sex presented with a lump Sign_symptom in her right Biological_structure breast Biological_structure .
She had macrocephaly Disease_disorder and milimetric Biological_attribute papules Sign_symptom on the tongue Biological_structure giving a cobble Texture stone Texture appearance.
The breast Biological_structure ultrasonography Diagnostic_procedure ( US Diagnostic_procedure ) showed more Lab_value than Lab_value twenty Lab_value circumscribed Detailed_description , oval Shape masses Disease_disorder in each breast Biological_structure .
An US Detailed_description - guided Detailed_description core Detailed_description biopsy Diagnostic_procedure was performed for the palpable Detailed_description masses Disease_disorder which were confirmed as juvenile Detailed_description fibroadenomas Disease_disorder .
After the biopsy, a breast Biological_structure US Diagnostic_procedure was done as follow-up every Frequency 6 Frequency or Frequency 12 Frequency months Frequency for 3 Duration years Duration .
During the surveillance period, core Detailed_description biopsies Diagnostic_procedure were performed six Quantitative_concept times Quantitative_concept , followed by US Detailed_description - guided Detailed_description vacuum Detailed_description - assisted Detailed_description core Detailed_description needle Diagnostic_procedure excisions Diagnostic_procedure or surgical Diagnostic_procedure excisions Diagnostic_procedure of lesions Disease_disorder with increased Lab_value sizes Lab_value .
Pathologic Coreference results Coreference were fibroadenoma Disease_disorder , tubular Disease_disorder adenoma Disease_disorder or atypical Disease_disorder ductal Disease_disorder hyperplasia Disease_disorder ( ADH Disease_disorder ) involving fibroadenoma Disease_disorder .
At Date the Date age Age of Age 19 Age years Age , the patient underwent a neck Biological_structure US Diagnostic_procedure for a palpable Detailed_description mass Disease_disorder in the left Biological_structure neck Biological_structure .
Several indeterminate Detailed_description nodules Sign_symptom were revealed in both Lab_value thyroid Biological_structure glands Biological_structure .
A follow Detailed_description - up Detailed_description US Diagnostic_procedure revealed that some Lab_value of those nodules Sign_symptom increased Lab_value in Lab_value size Lab_value .
The patient underwent a total Detailed_description thyroidectomy Therapeutic_procedure and the pathologic result revealed an invasive Detailed_description follicular Disease_disorder carcinoma Disease_disorder in the left Biological_structure thyroid Biological_structure and follicular Disease_disorder adenoma Disease_disorder in the right Biological_structure thyroid Biological_structure (Fig.1A).
At Date the Date age Date of Date 21 Date years Date , she visited Clinical_event the hospital Nonbiological_location due to a swelling Sign_symptom of her left Biological_structure cheek Biological_structure .
Head Biological_structure and neck Biological_structure CT Diagnostic_procedure scan Diagnostic_procedure revealed a vascular Biological_structure mass Disease_disorder in the left Biological_structure parotid Biological_structure gland Biological_structure extended into the left Biological_structure forehead Biological_structure .
An external Biological_structure carotid Biological_structure angiography Diagnostic_procedure confirmed the diagnosis of an AVM Disease_disorder with feeder Biological_structure vessel Biological_structure arising from the left Biological_structure internal Biological_structure maxillary Biological_structure artery Biological_structure (Fig.1B).
A partial Detailed_description embolization Therapeutic_procedure decreased Lab_value the blood Diagnostic_procedure flow Diagnostic_procedure through the AVM Disease_disorder , alleviating the Coreference patient's Coreference symptom Coreference .
She was referred to genetic Therapeutic_procedure counseling Therapeutic_procedure under the suggestion of a Cowden Disease_disorder syndrome Disease_disorder and the PTEN Diagnostic_procedure DNA Diagnostic_procedure sequencing Diagnostic_procedure test Diagnostic_procedure of her blood Diagnostic_procedure sample Diagnostic_procedure revealed a frameshift Diagnostic_procedure mutation Diagnostic_procedure , c.301dupA Diagnostic_procedure ( p.I101NfsX6 Diagnostic_procedure ).
At Date the Date age Date of Date 22 Date years Date , the patient presented with a mass Disease_disorder with increased Lab_value size Lab_value and increased Lab_value vascularity Lab_value in the left Biological_structure breast Biological_structure .
An US Detailed_description - guided Detailed_description vacuum Detailed_description - assisted Detailed_description core Detailed_description needle Diagnostic_procedure excision Diagnostic_procedure revealed a ductal Disease_disorder carcinoma Disease_disorder in Disease_disorder situ Disease_disorder ( DCIS Disease_disorder ) of non Detailed_description - comedo Detailed_description type Detailed_description and a low Lab_value grade Lab_value involving fibroadenoma Disease_disorder (Fig.1C).
The contrast Detailed_description - enhanced Detailed_description breast Biological_structure MRI Diagnostic_procedure for the preoperative evaluation demonstrated multiple Lab_value , well Detailed_description - circumscribed Detailed_description , enhancing Lab_value masses Disease_disorder in both Lab_value breasts Biological_structure (Fig.1D).
All Lab_value masses Disease_disorder showed high Severity or intermediate Severity signal Diagnostic_procedure intensity Diagnostic_procedure on T2 Diagnostic_procedure - weighted Diagnostic_procedure images Diagnostic_procedure (Fig.1E).
Several Lab_value masses Disease_disorder showed an early Detailed_description rapid Detailed_description enhancement Detailed_description with washout Diagnostic_procedure kinetic Diagnostic_procedure pattern Diagnostic_procedure on time Diagnostic_procedure - signal Diagnostic_procedure intensity Diagnostic_procedure curve Diagnostic_procedure evaluation Diagnostic_procedure , which tends to be associated with malignancy Disease_disorder (Fig.1F).
A bilateral Detailed_description prophylactic Detailed_description mastectomy Therapeutic_procedure with immediate Detailed_description breast Therapeutic_procedure reconstruction Therapeutic_procedure was performed in view of multiple Lab_value bilateral Detailed_description breast Biological_structure masses Disease_disorder with suspicious Detailed_description kinetic Diagnostic_procedure features Diagnostic_procedure on breast Biological_structure MRI Diagnostic_procedure and a high risk for breast Disease_disorder cancer Disease_disorder of Cowden Disease_disorder syndrome Disease_disorder .
The surgical Diagnostic_procedure histopathology Diagnostic_procedure revealed ADH Disease_disorder involving tubular Disease_disorder adenoma Disease_disorder without residual Detailed_description carcinoma Disease_disorder in the left Biological_structure breast Biological_structure and multiple Lab_value tubular Disease_disorder adenomas Disease_disorder , fibroadenomas Disease_disorder and intraductal Disease_disorder papillomas Disease_disorder in both Lab_value breasts Biological_structure .
The patient had no family history of breast Disease_disorder cancer Disease_disorder or Cowden Disease_disorder syndrome Disease_disorder .