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Figure 1. (a) Both mediolateral oblique mammograms show a well-circumscribed, multi-lobulated isodensity mass replacing the whole left breast (arrows). No calcification is seen. (b) Ultrasound shows a poorly defined, multiseptated cystic mass replacing her left breast. (c) T2 weighted and (d) pre-contrast T1 high resolution isotropic volume examination (3D T1 weighted gradient echo sequence with fat suppression) MR images at the same level reveal a 12 cm x 12 cm mass with various signal intense multiseptated cysts (arrows) occupying the bulk of the left breast. Some cysts had a fluid-to-fluid level (arrowhead). (e) Three-dimensional T1 weighted gradient echo sequence with fat suppression (subtraction) at 120 s after contrast injection shows heterogeneous enhancement in the peripheral portion of the mass (arrows) in the early phase. (f) Three-dimensional T1 weighted gradient echo sequence with fat suppression (subtraction) at 360 s after contrast injection shows heterogeneous enhancement in the peripheral portion of the mass (arrows) in the delayed phase. (g) Photomicrograph of a mastectomy specimen shows an ill-defined firm mass measuring 13.5 cm x 12 cm x 6 cm consisting of numerous and variable-sized small cysts (arrows). The cysts were 0.1 cm to 4 cm in their greatest dimension and had a spongy appearance. The cystic spaces were filled with haemorrhagic fluid. (h) Photomicrograph of a mastectomy specimen shows dilated vessels (arrows) congested with red blood cells and lined with endothelial cells but without any atypical cells, thus suggesting cavernous haemangioma (haematoxylin and eosin x40).
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