Bibliographic record
Abstract
A 40-year-old man presented with a painless chest wall mass that had been growing insidiously for the last five years. Examination revealed a firm lobulated exophytic mass, 7 cm inferior to the right nipple (Figure 1) in the milk line in a right supernumerary nipple. The patient had a supernumerary nipple on the contralateral side with a normal appearance on the breast ultrasound (Figure 2). A mass lesion shows gross calcifications on mammography (Figure 3) and heterogeneous internal enhancement on postcontrast magnetic resonance imaging (Figure 4). Core needle biopsy pathology results showed the presence of abundant cartilage and epithelial cells distributed as tubules and groups of squamous islands surrounded by a fibrous stroma. Large keratin filled cysts were seen. No evidence of atypia or malignancy was reported. The tumor was surgically removed, and histology (Figure 5) confirmed diagnosis of a pleomorphic adenoma (PA) benign mixed tumor of the breast. Healing was uneventful, and the patient showed no signs of recurrence at the end of the 46-month follow-up period. Pleomorphic adenoma is the most common tumor type in the salivary glands. Unlike salivary gland PAs, management guidelines for PAs are poorly defined in the breast gland. Because of the risk of recurrence and malignant transformation in PA of the breast, complete excision of the lesion with a cuff of normal tissue, as is the practice in the salivary gland, has been advised. Clinicians should be aware of the condition, as preoperative diagnosis will facilitate adequate surgery. A 40-year-old man with an exophytic mass in the right supernumerary nipple, shown in the frontal view (A) and the lateral view (B) of the tumor (pleomorphic adenoma) with a large base. A 40-year-old man with an exophytic mass in the right supernumerary nipple, shown in the frontal view (A) and the lateral view (B) of the tumor (pleomorphic adenoma) with a large base. sonographic appearance of the solid mass lesion (arrows) with hypoechoic heterogeneous internal echoes and well-defined margins in the right supernumerary nipple (A) compared with the anatomic normal sonographic morphology of the contralateral supernumerary nipple (B, arrows). sonographic appearance of the solid mass lesion (arrows) with hypoechoic heterogeneous internal echoes and well-defined margins in the right supernumerary nipple (A) compared with the anatomic normal sonographic morphology of the contralateral supernumerary nipple (B, arrows). Bilateral digital mammography shows the right supernumerary nipple deformed by the presence of a large circumscribed mass (arrows) with associated coarse calcifications and no evidence of any abnormalities in the contralateral breast. Bilateral digital mammography shows the right supernumerary nipple deformed by the presence of a large circumscribed mass (arrows) with associated coarse calcifications and no evidence of any abnormalities in the contralateral breast. Breast MRI demonstrates a T2 (A) hyperintense mass in the right breast (arrow). Post–gadolinium T1-weighted sequences (B and C) show a well-defined mass in the right breast with heterogeneous enhancement (arrows). Breast MRI demonstrates a T2 (A) hyperintense mass in the right breast (arrow). Post–gadolinium T1-weighted sequences (B and C) show a well-defined mass in the right breast with heterogeneous enhancement (arrows). histologic slide (x 400) with H & E stain demonstrating proliferation of a mix of parenchymatous epithelial cells (open arrow) along with myoepithelial (arrowhead) components associated to abundant myxomatous stroma. Calcification (arrow) is partially visualized in this field of the excision specimen. histologic slide (x 400) with H & E stain demonstrating proliferation of a mix of parenchymatous epithelial cells (open arrow) along with myoepithelial (arrowhead) components associated to abundant myxomatous stroma. Calcification (arrow) is partially visualized in this field of the excision specimen. None declared.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.008 |
| Meta-epidemiology (narrow) | 0.003 | 0.002 |
| Meta-epidemiology (broad) | 0.002 | 0.002 |
| Bibliometrics | 0.005 | 0.002 |
| Science and technology studies | 0.003 | 0.002 |
| Scholarly communication | 0.003 | 0.004 |
| Open science | 0.003 | 0.003 |
| Research integrity | 0.009 | 0.004 |
| Insufficient payload (model declined to judge) | 0.010 | 0.004 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".