To knowthe causes of circumscribed giant solid breast masses and the role of US and mammography in diagnosis of these lesions.

It is a tragic fact that in developing countries, many patients present late with giant breast masses. Giant breast masses are those larger than 5 cm across. A wide variety of breast conditions such as lipoma, hamartoma, cyst, fibroadenoma, phyllodes tumour, haematoma, abscess and carcinoma can result in solitary or multiple giant masses. Giant well circumscribed breast masses include:- 1.Giant fibroadenoma. 2.Phyllodes tumour. 3.Malignat masses as medullary carcinoma & primary lymphoma.1 Table 1: Demographics and imaging findings suggestive of diagnosis of giant fibroadenoma and phyllodes...

16 patients with giant breast masses were imaged,the youngest patient was 12 years old & the oldest was 49 years. Pathological diagnosis revealed 8 patients to have phyllodes tumor, 7 as giant fibroadenoma & 1 as medullary carcinoma. Patient`s older agewith rapid progressive clinicalcourse together with mammographic findings of well circumscribed high density mass & sonographic findings of heterogeneous internal echogenicity, presence of cystic components and posterior enhancement can suggest the diagnosis of phyllodes tumor.

A circumscribed mass without fat density on mammogram and that is solid on US may arise from many causes and cannot be differentiated from each other on the basis of imaging alone. A tissue diagnosis is warranted in this group of patients with the consideration of malignant neoplastic masses as medullary carcinoma & lymphoma as possible causes.

1.Muttarak M, Chaiwun B. Imaging of giant breast masses with pathological correlation. 2004;45(3):132–9 2.Parker SJ, Harries SA. Phyllodes tumours. 2001;428–35. 3.Eyl D. DIFFERENTIATION OF PHYLLODES TUMORS VERSUS FIBROADENOMAS Mammographic and sonographic features. 2002;43:34–9.