PMC6069371_01
(a) Clinical examination of the patient showing a midline dorsal accessory breast with 3 nipples (2 well formed and 1 rudimentary). (b) Close up view
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F1
On examination, the swelling was soft-to-firm, nontender, midline in location, which started increasing in size at puberty and progressed since then to the present size of 14 cm x 12 cm [Figure 1].
(a and b) 3D Computed Tomography (CT) scan of the dorsal spine showing a wide bony defect in the posterior spinal elements from D3 to D9 vertebrae. (c) Diastematomyelia is also seen
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F2
D3 to D9 vertebrae. Diastematomyelia was also seen from D3 to D7 vertebrae [Figure 2].
(a) Magnetic Resonance Imaging (MRI) of the dorsal spine suggestive of a complex spinal dysraphism with lipomeningomyelocele. (b) Diastematomyelia is also seen
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F3
Magnetic resonance imaging (MRI) of the dorsal spine was suggestive of a complex spinal dysraphism with lipomeningomyelocele and diastematomyelia [Figure 3].
Schematic diagram showing the relationship of occult spinal dysraphism (OSD) with dorsal accessory ectopic breast
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F4
Two hemicords with a dorsal type lipomeningomyelocele was identified [Figure 4].
(a) Hematoxylin and eosin stained section (x40) showing normal skin with appendages (single arrow); Subepithelial tissue shows lactiferous duct (double arrow). (b) Hematoxylin and eosin stained section (x80) showing lactiferous duct with secretion inside (single arrow) along with terminal duct lobular units of breast (double arrow). (c and d) Hematoxylin and eosin stained section (x20 and x40 respectively) showing lipomatous component composed of sheets of mature adipocytes with adjacent dural fibroblasts
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F5
Histopathological examination was consistent with accessory ectopic breast with lipomeningomyelocele [Figure 5].