Applied Radiology

A10-year-old black girl pre-sented to her pediatrician with marked bilateral breast enlargement with asymmetry. Following her second office visit for the same problem, a mammogram was ordered and completed at the insistence of the clinician (figure 1). The presence of dense tissue limited the usefulness of this modality. However, on clinical exam, mobile hard discrete masses were palpated bilaterally (figure 2) with a small amount of normal soft tissue identified in the inferior left breast. Bilateral breast sonography with Doppler interrogation (figure 3) revealed well-defined solid hyperechoic masses with a few vascular channels. At surgery, two masses were removed from the right breast, and one mass from the left breast (figure 4).