Intraductal papillary carcinoma

case4

Clinical History:

A 69 year old female patient with hemorrhagic nipple discharge on the left side. Clinical assessment revealed no palpable mass, and no signs of inflammation. Mammography and ultrasound were within normal limits.

Diagnosis:

Intraductal papillary carcinoma

MR Technique: 

1.5-T system (Magnetom Avanto, Siemens Healthcare, Erlangen, Germany) using a standard bilateral breast coil. (A) Unenhanced T1-weighted 3D gradient-echo sequence (1.6 mm axial slice, field of view 320 mm, matrix 512×512, TR/TE 4/1.5 ms) (B) T1-weighted 3D gradient-echo sequence (1.6 mm axial slice, field of view 320 mm, matrix 512×512, TR/TE 4/1.5 ms, acquired every 50 s) after bolus injection of 0.2 mmol of Gd-DOTA per kilogram of body weight, 3rd of 6 series. (C) Representative signal-intensity time curve. (D) Corresponding subtracted T1-weighted 3D gradient-echo post contrast images, MIP.

Imaging Findings:

A 2 cm tubular lesion related to the central duct with prominent contrast enhancement and smooth margins is visualized. Analysis of enhancement kinetics showed a type II signal-intensity time curve (rapid signal increase followed by a plateau). After second-look ultrasound and core cut biopsy an intraductal papillary carcinoma was found histologically.