E5042. Multimodality Imaging Features of Cystic Lesions in the Male Breasts
  1. Aparna Tompe; Geisinger Medical Center
  2. Sargar Kiran; Geisinger Medical Center
Cystic lesions are rare in male breasts, and radiologists may not be familiar with the spectrum and clinical and imaging features of these cystic lesions. Given their rarity of cystic lesions in male breast, radiologists may perform unnecessary biopsies of these cystic lesions, even though imaging features are highly suggestive of benign cysts.

Educational Goals / Teaching Points
To demonstrate multimodality imaging features of cystic lesions in the male breasts in a case-based format and to discuss key imaging features to differentiate benign cystic lesions from malignant cystic lesions and other male breast pathologies.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
Although cysts are the most common masses in female breasts, they are quite rare in male breasts. In this presentation, we will highlight the brief imaging anatomy of male breast, spectrum of benign and malignant cystic lesions in male breasts, and their typical multimodality imaging features on mammography, ultrasonography, and MRI using case-based format. We will also include relevant pathology slides to demonstrate typical histopathological findings. Common benign cystic lesions in male breasts include sebaceous cyst (epidermal inclusion cyst), fat necrosis, hematoma, abscess, focal duct ectasia, and papilloma. The most common malignant cystic lesion is papillary carcinoma. Most important imaging features distinguishing malignant from benign cystic lesions in male breasts include ill-defined margins, irregular shape, solid components, thick wall or septations, or internal vascularity. Any of these features warrant further evaluation with needle biopsy. In absence of these suspicious imaging features, cysts in male breasts can be confidently classified as benign cysts and needle biopsy can be avoided.

The knowledge of spectrum and key imaging features of cystic lesions in male breasts is helpful for the radiologist to distinguish benign from malignant cystic lesions, which is essential for appropriate management and prognostication.