POLAND SYNDROME AND BREAST CANCER: CASE REPORT

Camargo Júnior, H. S. A. (CDE Diagnóstico por Imagem, Campinas, SP, Brasil.), Camargo, M. M. A. (CDE Diagnóstico por Imagem, Campinas, SP, Brasil.), Teixeira, S. R. C. (CDE Diagnóstico por Imagem, Campinas, SP, Brasil.), Azevedo, J. (CDE Diagnóstico por I

CDE Diagnóstico por Imagem, Campinas, SP, Brasil.We present an unusual case of breast cancer in a patient with Poland’s syndrome. Besides being unusual, it bears a particularly illustrative iconographic documentation of how this syndrome is associated with hypoplasia of the sternocostal portion of the pectoralis major only. It is also a good example of how a striking finding can go unnoticed in the face of an even more striking other finding. A 36-year-old patient underwent MRI before neoadjuvant chemotherapy treatment. The pectoral hypoplasia went unnoticed, but in the control MRI after treatment, when the tumor had disappeared, it was perceived. The tomography performed for oncologic staging offered a beautiful demonstration of the hypoplasia of the sternocostal portion of the breast but with the sternoumeral portion present, especially in its 3D reconstruction. In this patient, the large tumor present at the initial diagnosis diverted our attention from the hypoplasia of the pectoralis major. We usually think of Poland’s syndrome as hypoplasia of the whole pectoralis major muscle, with or without breast or upper limb associated hypoplasia. Actually, this rare congenital anomaly comprises hypoplasia only of the sternocostal part of this muscle, which is nicely demonstrated in the CT reconstruction. Poland’s syndrome has been described in association with leukemia, lymphoma, leiomyosarcoma, kidney tumors and breast cancer (7 cases so far in the literature). We revisit the concept that a large anomaly can impair our capacity to detect a lesser finding. Also, we report the rare association between Poland’s syndrome and breast cancer and present a beautiful iconographic demonstration of the little appreciated parcial hypoplasia of the pectoralis major which is the hallmark of Poland’s.Breast-Cancer, Poland.

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