Adenomyoepithelioma of the Breast: A Report of 3 Cases (original) (raw)
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World Journal of Surgical Oncology, 2013
Background: Breast adenomyoepithelioma is an unusual tumor characterized by a biphasic proliferation of epithelial and myoepithelial cells. Most breast adenomyoepitheliomas are considered to be benign or to have a low-grade malignant potential, characterized by propensity for local recurrence. Malignant changes arising in this lesion are extremely rare and may involve one or both cellular components. Case report: We discuss a case of a 60 year-old woman who began to experience pain in her right breast in January 2009. Breast ultrasound and mammography were performed showing a rounded, hypoechoic solid lesion with ill-defined margins in the right inner-inferior quadrant, suspicious of malignancy. Quadrantectomy of the innerinferior quadrant of the right breast with sampling of ipsilateral axillary lymph nodes was performed. The histological analysis confirmed the diagnosis of adenomyoepithelioma with focal malignant change of the epithelial component, associated with high-grade malignant myoepithelial change. The patient was treated with adjuvant radiotherapy and her right breast received a dose of Gy 50 with a boost of Gy 10 to the tumor bed. At present, the patient shows no sign of tumor recurrence. Conclusion: Breast malignant adenomyoepithelioma is a rare tumor which should be considered in the differential diagnosis of other solid breast lesions. Only few cases have been reported in the literature. Diagnosis, optimal therapy and predicting the outcome are problematic issues due to the rarity of this disease which appears to have hematogenous rather than lymphatic spread and usually occurs in primary tumors ≥ 1.6 cm in size.
Adenomyoepithelioma of the breast as a diagnostic problem
2009
Adenomyoepitheliomas are extremely rare breast tumours that were not described and classified until after the1990s. They are characterised by biphasic proliferation of ductal and myoepithelial cells organised in ribbon-like, solid, tubular or lobular arrangements. During years adenomyoepithelioma represent poorly understandable diagnostic entity which biological behaviour cannot be always predicted on the basis of the cytological characteristics and histological architecture. Diagnosis by clinical examination and imaging studies remains difficult, and frozen sections of selected areas can potentially be misdiagnosed as malignant. In this study, we present a case of a breast adenomyoepithelioma in 68-year-old woman. The diagnosis was made with immunohistochemistry following a surgical excision.
Adenomyoepithelioma of the Breast: An Intricate Diagnostic Problem
Breast Care, 2008
Hintergrund: Das Adenomyoepitheliom (AME) der Brust ist ein seltener, biphasischer Tumor mit epithelialen/myoepithelialen Anteilen. In einer Gewebeprobe ist ein AME leicht zu diagnostizieren, anhand einer Nadelbiopsie ist die sichere Diagnosestellung jedoch erschwert. Fallbericht: Wir berichten über den Fall einer 42-jährigen Patientin, die mit einem Knoten in der rechten Brust vorstellig wurde. Die Feinnadelbiopsie ergab ein C5-Karzinom. Der Patientin wurde eine neoadjuvante Therapie empfohlen, welche sie jedoch ablehnte. Daraufhin wurde sie an ein spezialisiertes Zentrum überwiesen, wo eine Nadelbiopsie durchgeführt wurde und die Diagnose eines möglichen AME gestellt wurde. Schlussfolgerung: Bei zytologischern Atypien in Nadelbiopsien kann es auf Grund der geringen Gewebemenge zur Verwechslung eines AME mit einem invasiven Duktalkarzinom kommen.
Adenomyoepithelioma of the breast with unusual confounding diagnostic feature: a case report
Journal of Medical Case Reports
Background Adenomyoepithelioma of the breast is an uncommon subtype of breast neoplasm that occurs in adults over a wide age range but most commonly in middle-aged and older adults. It usually presents as a solitary palpable mass or is detected on breast radiographic images. Histologically, it is a biphasic tumor with proliferation of both the epithelial and myoepithelial components of the glands, with variable types of tissue metaplasia. Case presentation A 64-year-old Saudi woman who underwent regular breast screening (mammogram) presented to our hospital following radiographic detection of a suspicious grouped microcalcification in the upper outer quadrant of her right breast on the mammogram. A wide local excision of the right breast lump was performed. Following histopathological examination of the breast lump, the final diagnosis was breast adenomyoepithelioma with mucoepidermoid/divergent differentiation, with no evidence of malignancy. About two years after the operation, a ...
Breast Care, 2008
Hintergrund: Myoepitheliale Zellen sind überall in der Brust zu finden. Eine Hyperplasie dieser Zellen kann zu einem weiten Erkrankungsspektrum von Myoepitheliose bis hin zu myoepithelialen Karzinomen führen. Fallbericht: Eine 46-jährige Frau wurde mit einer tastbaren Geschwulst in der rechten Brust vorstellig. Die mammographische und Ultraschalluntersuchung zeigten eine Läsion mit spikulierter Begrenzung und Form im oberen Quadranten der rechten Brust. Die Untersuchung der Exzisionsbiopsie ergab eine adenomyoepitheliale Adenose. Schlussfolgerungen: Adenomyoepitheliale Läsionen gelten zwar als gutartig, auf Grund unvollständiger Entfernung rezidivieren sie aber häufig. Deshalb sollte das mögliche Auftreten von Rezidiven und sogar Metastasen während des Follow-ups von Patienten mit adenomyoepithelialen Läsionen im Auge behalten werden.
Case Report Adenomyoepithelioma of breast Adenomyoepithelioma Of Breast : Report Of A Rare Case
2016
Benign adenomyoepithelioma of the breast is a rare tumor characterized by biphasic proliferation of both an inner layer of epithelial cells and a prominent peripheral layer of myoepithelial cells. This entity may rarely progresses to a more malignant state or gives rise to metastasis. Accurate diagnosis and close follow up is essential for proper treatment of these tumors. We report a 15 year old girl who presented with large lump in the breast which was clinically mistaken for a giant fibroadenoma of breast. No nodes were palpable. On gross examination, a large lump 11x11x8 cm was noted which was well circumscribed, solid on cut section. On histopathologic examination the diagnosis of adenomyoepithelioma was made which was further supported by immunohistochemistry findings.
Diagnostic Cytopathology, 1998
Adenomyoepithelioma is a rare breast tumor. Histologically it may disclose different patterns of growth, and some additional features may result in diagnostic errors. We describe 2 cases of adenomyoepithelioma of the breast initially examined by fine-needle aspiration biopsy (FNAB). Cytologic features included hypercellularity, clusters of epithelial and myoepithelial cells with occasional intranuclear inclusions, prominent apocrine metaplasia, and foam cells. Histologically, both tumors were diagnosed as adenomyoepithelioma tubular-variant, with prominent myoepithelial clear cells, apocrine metaplasia, and foci of squamous metaplasia. Immunohistochemically, the tumors showed strong positivity for keratins CAM 5.2, AE1/AE3, and EMA in the epithelial component, while the myoepithelial cells reacted with muscle-specific actin (A14 and HHF35) and S-100 protein. We point out that FNAB in this rare tumor may exhibit a varied spectrum of cells that may result in confusion with other lesions, and we call attention to the presence of intranuclear inclusions. The latter observation in the present cases by cytologic and histologic assessment provides an additional feature to the morphological characteristics of adenomyoepithelioma of the breast.
Adenomyoepithelioma of the breast
Diagnostic Cytopathology, 2001
Adenomyoepithelioma is a rare breast tumor. Histologically it may disclose different patterns of growth, and some additional features may result in diagnostic errors. We describe 2 cases of adenomyoepithelioma of the breast initially examined by fine-needle aspiration biopsy (FNAB)
Adenomyoepithelioma of the breast: a proposal for classification
Histopathology, 2021
Breast lesions with a prominent myoepithelial cell component constitute a heterogeneous group of benign and malignant neoplastic proliferations. These lesions are often dual epithelial-myoepithelial, but may be purely myoepithelial cell in nature. Benign epithelial-myoepithelial lesions typically maintain the morphology and immunophenotype of the normal bilayer epithelial myoepithelial structures. However, the distinction between the two cell components is not always clear-cut in malignant lesions in which the histogenesis of myoepithelial cells remains uncertain. Neoplastic biphasic epithelial-myoepithelial lesions of the breast include adenomyoepithelioma (AME), pleomorphic adenoma and adenoid cystic carcinoma. Four histological patterns of classical AME have been described: tubular, lobulated, spindle-cell and adenosis variants. Overlapping patterns occur and some AMEs display an intraductal papillary pattern that may represent a fifth variant. AME can be benign or malignant. Classical AME may show atypical features, which are not sufficient for the diagnosis of malignancy (atypical AME). Atypical AME is recognised as a lesion of uncertain malignant potential with limited metastatic capability. Based on the histological features, we propose a classification of malignant AME (M-AME) into three variants: M-AME in situ, M-AME invasive and AME with invasive carcinoma. In this review, we provide an overview of myoepithelial lesions of the breast focusing on the classification of AME to improve not only the consistency of reporting but also help to guide further management decision-making.