PMC6796500_01
Mammography of the tumor before treatment.. Mammography showing a round, microlobulated, high-density, 48-mm diameter mass at (a) middle-anterior of mediolateral oblique (MLO) view and (b) posterior-middle at craniocaudal view (CC) view. No calcifications were noted.
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No calcifications were detected (Fig. 1).
Ultrasonography of the tumor before treatment.. (a) Ultrasonogram showing a mass with the following characteristics: oval shape; irregular margin; almost parallel to skin; internal echo mixed with hypo and hyperechoic pattern; and slightly enhanced posterior features. The spiculated, 22-mm diameter mass was adjacent to the inner side of the main tumor (curved arrow).. (b) Color doppler sonogram showing internal vascularity (arrows)
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Color doppler sonogram showed internal vascularity (Fig. 2).
MRI images of the tumor before treatment.. (a) T2-weighted image showing a smooth mass with inhomogeneous high-intensity signal surrounded by strong hypointense rim (arrows).. (b) Non-contrast enhanced T1-weighted image with fat saturation showing speckled high-intensity signal inside the mass (arrow).. (c) (d) Gadolinium-enhanced T1-weighted image with fat saturation 20 s and 85 s after contrast media injection showing very weak and heterogenous enhancement.
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Netlike septum with low-signal intensity on T1/T2-weighted image and speckled high intensity area on T1-weighted image were observed inside the tumor (Fig. 3).
Mammography of the tumor after neoadjuvant chemotherapy.. (a)(b) Mammography after neoadjuvant chemotherapy showing a spiculated mass with calcification-like high density.
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Mammography showed a 16-mm spiculated mass with calcification-like high density (Fig. 4).
Ultrasonography of the tumor after neoadjuvant chemotherapy.. (a)(b) Ultrasonogram after neoadjuvant chemotherapy showing an oval, spiculated mass with internal vascularity (arrow).
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Ultrasonogram also revealed tumor shrinkage, as well as oval, spiculated, and internal vascularity features (Fig. 5).
MRI images of the tumor after neoadjuvant chemotherapy.. (a) T2-weighted image, (b) non-contrasted T1-weighted image with fat saturation, (c)(d) gadolinium-enhanced T1-weighted image with fat saturation 20 s and 85 s after contrast media injection showing strong susceptibility artifact.
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At gadolinium-enhanced MRI, a large susceptibility artifact was observed at tumor location, precluding interpretation of MRI image (Fig.6).
Pathological findings of resected specimen.. (a) Macroscopic findings and (b) cut specimen showing spiculated rust-colored mass. (c) Histopathological findings and (d) Prussian blue iron stain showing blue massive hemosiderin deposition granules at interstitial space. The surgical specimen confirmed tumor pathological complete response. No calcifications were noted.
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No calcification was observed (Fig. 7).