Pilomatrixoma, a Rare Mimicker of Male Breast Cancer

Pilomatrixoma or calcifying epithelioma of Malherbe is a benign skin tumor arising from the hair follicle; breast occurrence is considered a rarity. Clinically presenting as a palpable abnormality and with both benign and malignant mammographic and sonographic features, it can be easily misdiagnosed as a breast neoplasm. We report a very rare case of pilomatrixoma of the male breast in a 36-year-old male presenting with a firm, superficial nodule in the upper outer quadrant. Though the sonographic trifecta of imaging features (shape- margins-orientation/oval, circumscribed mass, parallel to the skin) is consistent with a benign lesion, a histologic diagnosis was warranted based on its most suspicious feature of internal pleomorphic calcifications. Pathologic diagnosis revealed the uncommon benign entity of pilomatrixoma in the male breast. Our patient was recommended for surgical excision based on current literature recommendations for management in most reports of pilomatrixoma. One alternative recommendation presented in a single report of pilomatrixoma in the breast supported follow-up imaging based on benign imaging characteristics.

Peer Problems and Low Self-esteem Mediate the Suspicious and Non-suspicious Schizotypy–Reactive Aggression Relationship in Children and Adolescents

The relationship between schizophrenia and violence has been well-established. Yet very little prior research exists on the factors that might explain the nature of this relationship and even fewer studies seek to clarify the etiology of aggressive behavior in adolescents with specific features of schizotypal personality that might help improve the specificity of intervention. The current study tested whether one dimension of schizotypy alone (i.e., the ‘suspicious’ feature) or the other 8 dimensions (i.e., the ‘non-suspicious’ features) were particularly associated with aggressive behaviors (reactive and proactive aggression), and if peer problems and low self-esteem mediated these relationships. A serial multiple mediation model testing the hypothesized flow from suspicious and non-suspicious schizotypy to peer problems to low self-esteem and to increased aggression was tested in Hong Kong schoolchildren aged 8- to 14-years (N = 1412; Mage = 11.47, SD = 1.67 years, female = 47.6%). Increased suspicious and non-suspicious schizotypal features were found to be independently associated with increased reactive aggression, but not proactive aggression. Children with high levels of suspicious schizotypy and non-suspicious schizotypy were more likely to have poor peer problems and low self-esteem concurrently, which in turn was associated with reactive aggression only. This explanatory model suggests that future longitudinal intervention studies that enhance self-esteem in schizotypal adolescents may potentially reduce co-morbid reactive aggressive behaviors too.

Mammographic CAD: Correlation of regions in ipsilateral views - a pilot study

Background: Radiologists analyse both standard mammographic views of a breast to confirm the presence of abnormalities and reduce false-positives. However, at present no computer-aided diagnosis system uses ipsilateral mammograms to confirm the presence of suspicious features. Aim: The aim of this study was to develop image-processing algorithms that can be used to match a suspicious feature from one mammographic view to the same feature in another mammographic view of the same breast. This algorithm can be incorporated into a computer-aided diagnosis package to confirm the presence of suspicious features. Method: The algorithms were applied to 68 matched pairs of cranio-caudal and mediolateral-oblique mammograms. The results of this pilot study take the form of maps of similarity. A novel method of evaluating the similarity maps is presented, using the area under the receiver operating characteristic curve (AUC) and the contrast (C) between the area of the matched region and the background of the similarity map. Results and Conclusions: The first matching algorithm (using texture measures extracted from a grey-level co-occurrence matrix (GLCM) and a Euclidean distance similarity metric) achieved an average AUC=0.80±0.17 with an average C=0.46±0.26. The second algorithm (using GLCMs and a mutual information similarity metric) achieved an average AUC=0.77±0.25 with an average C=0.50±0.42. The latter algorithm also performed remarkably well with the matching of malignant masses and achieved an average AUC=0.96±0.05 with an average C=0.90±0.21.