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Althoubaity F, Wazira LA, Ahmad HMY, Aljuhani RT. Concurrence of Adenomyoepithelioma of the Breast and Gastrointestinal Stromal Tumor of the Stomach: A Case Report and Review of the Literature. Med Sci (Basel) 2023; 11:57. [PMID: 37755162 PMCID: PMC10537318 DOI: 10.3390/medsci11030057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Revised: 08/25/2023] [Accepted: 09/06/2023] [Indexed: 09/28/2023] Open
Abstract
Adenomyoepithelioma (AME) of the breast and gastrointestinal stromal tumors (GISTs) are rare benign (primarily) tumors observed in the breast and gastrointestinal tract, respectively. The coexistence of both of these rare tumors is extremely rare; therefore, the author describes the clinical presentation and pathophysiological findings of such a unique case in this study. A 56-year-old female patient with no medical history presented with a substantial right breast lump, severe nausea, and vomiting, and suffered from iron deficiency anemia. Radiological observation and a right breast excisional biopsy diagnosed the patient with AME associated with ductal carcinoma in situ (DCIS). Endoscopy and a CT scan of the stomach revealed the existence of GIST. This is the first reported case of concurrence of a huge mass of AME and GIST in a patient. Histological and immunohistochemistry tests using p63, SMA, calponin, and Ki67 markers for the breast tumor and DOG-1, CD34, and CD117 markers for the gastric tumor revealed the non-invasive benign state. The patient had a right breast mastectomy with a negative resection margin. AME of the breast and GIST pose diagnostic challenges due to their erratic morphological characteristics and can cause misinterpretation drawn solely from radiological tests. Effective and accurate diagnostics require assessing the histological and immunohistochemistry findings of the tumor to identify the invasiveness of the neoplasm and the associated risk levels. This report, thus, creates awareness among clinicians and pathologists for the consideration of such possibilities and, therefore, conducts the necessary diagnostics and prophylactic treatments.
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Affiliation(s)
- Fatma Althoubaity
- Department of Surgery, King Abdulaziz University Hospital, Jeddah 21589, Saudi Arabia
| | - Lamar A Wazira
- Department of Surgery, Collage of medicine, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Hanin M Y Ahmad
- Department of Surgery, Collage of medicine, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Reyof T Aljuhani
- Department of Surgery, Collage of medicine, King Abdulaziz University, Jeddah 21589, Saudi Arabia
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Al Mulla L, Abdelhadi M, Al Muhanna A, Elsharkawy T, Al Nemer A. Adenomyoepithelioma of the breast with unusual confounding diagnostic feature: a case report. J Med Case Rep 2022; 16:302. [PMID: 35934703 PMCID: PMC9358805 DOI: 10.1186/s13256-022-03507-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 06/26/2022] [Indexed: 11/14/2022] Open
Abstract
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 clinical follow-up conducted outside our hospital showed the development of ductal carcinoma in situ in the same breast. Conclusion Although the prognosis and the plan of treatment remains the same, our case highlights the complexities in making an accurate diagnosis between the various types of metaplasia within adenomyoepithelioma on one hand and the presence of mucoepidermoid differentiation in adenomyoepithelioma on the other.
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Belhaddad EH, Souabni SA, Nejmaddine K, Oubahha I, Aboulfalah A, Soummani A. Benign adenomyoepithelioma of the breast: a case report. Pan Afr Med J 2022; 41:7. [PMID: 35145599 PMCID: PMC8797041 DOI: 10.11604/pamj.2022.41.7.28654] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 11/27/2021] [Indexed: 01/14/2023] Open
Abstract
The diagnosis of adenomyoepitheliomas is difficult and relies on the presence of a double component of epithelial and myoepithelial cells belonging to the breast lobules and ducts. The clinical and imaging characteristics are not specific; thus, the diagnosis is histological. In this article, we present a case of a young female who presented with a 2 cm lump in the breast without other clinical symptoms, which revealed a benign adenomyoepithelioma (AME). We performed a large excisional lumpectomy, and the patient recovered well with no complication or recurrence within two years follow-up. When it comes to adenomyoepitheliomas, the published literature is mainly composed of case reports, so much so that there are no evidence-based guidelines. Our case shows that an excisional lumpectomy is often enough when facing a small size tumor with no signs of malignancy, which contributes to the limited data on the subject.
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Affiliation(s)
- El Habib Belhaddad
- Faculty of Medicine and Pharmacy of Marrakesh, Cadi Ayyad University, Marrakesh, Morocco
| | - Sara Ait Souabni
- Faculty of Medicine and Pharmacy of Marrakesh, Cadi Ayyad University, Marrakesh, Morocco
| | - Khadija Nejmaddine
- Department of Obstetrics and Gynecology, University Hospital Mohammed VI, Marrakesh, Morocco
| | - Ihsane Oubahha
- Department of Obstetrics and Gynecology, University Hospital Mohammed VI, Marrakesh, Morocco
| | - Abderrahim Aboulfalah
- Department of Obstetrics and Gynecology, University Hospital Mohammed VI, Marrakesh, Morocco
| | - Abderraouf Soummani
- Department of Obstetrics and Gynecology, University Hospital Mohammed VI, Marrakesh, Morocco
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Jameel Z, Kiluk J, Rosa M. Malignant Adenomyoepithelioma of the Breast and Associated Epithelial-Myoepithelial Carcinoma; A Rare Case Report. Int J Surg Pathol 2022; 30:569-573. [PMID: 35138180 DOI: 10.1177/10668969211070164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Adenomyoepithelioma comprises a spectrum of lesions with variable morphology and clinical behavior, presenting at a wide age range. The most common presenting symptom is palpable abnormality. Mammographic abnormalities include focal asymmetries, masses and microcalcifications. Adenomyoepithelioma is a biphasic neoplasm characterized by proliferation of epithelial and myoepithelial cells. Adenomyoepitheliomas can be benign, atypical and malignant (adenomyoepithelioma with carcinoma). Malignant transformation occurs in either one or both cellular components leading to the development of invasive carcinoma. Invasive carcinoma types include invasive breast carcinoma of no special type, invasive lobular carcinoma, invasive carcinoma of special types, myoepithelial carcinoma, metaplastic carcinoma and biphasic carcinoma such as epithelial-myoepithelial carcinoma. While the majority of classic adenomyoepitheliomas have a benign clinical course and can be treated by local excision, local recurrence and distant metastasis have been reported. In malignant cases, treatment is determined by the associated carcinoma to include radiotherapy after breast conserving surgery and sentinel lymph node biopsy or axillary lymph node dissection, as indicated. Herein we report a case of a 62 year old woman who was found to have focal asymmetry on screening mammogram. She underwent a core biopsy of the lesion which showed atypical epithelial-myoepithelial neoplasm and excision was recommended. Upon excision, a diagnosis of malignant adenomyoepithelioma with associated epithelial-myoepithelial carcinoma was rendered with negative margins. The patient declined additional surgery for sentinel lymph node biopsy and declined adjuvant therapy. Six months after surgery, the patient is doing well with no complains. A follow-up mammogram and ultrasound of the axilla showed no abnormalities.
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Affiliation(s)
- Zena Jameel
- 25301Moffitt Cancer Center, Tampa, FL, USA.,University of South Florida, Tampa, FL, USA
| | - John Kiluk
- 25301Moffitt Cancer Center, Tampa, FL, USA.,University of South Florida, Tampa, FL, USA
| | - Marilin Rosa
- 25301Moffitt Cancer Center, Tampa, FL, USA.,University of South Florida, Tampa, FL, USA
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Spyrou A, Katsourakis A, Chytas D, Komsis G, Chatzis I, Pantelidou P, Konstantinidis S, Noussios G. Combination of Adenomyoepithelioma and Adenoid Cystic Carcinoma of the Breast: A Case Report of an Uncommon Histopathological Entity. Am J Case Rep 2022; 23:e934391. [PMID: 35064096 PMCID: PMC8793792 DOI: 10.12659/ajcr.934391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Adenomyoepithelioma and adenoid cystic carcinoma are uncommon types of breast tumors. Adenoid cystic carcinoma accounts for 0.1% of breast neoplasms and typically presents as a tender breast tumor, mostly in the subareolar area. Adenoid cystic carcinoma usually appears in women in the fifth or sixth decade of life and predominantly presents as a mixed tumor, with cribriform, tubular, and solid growth characteristics. Adenomyoepithelioma of the breast shows epithelial and smooth muscle characteristics. Adenomyoepithelioma rarely goes through malignant transformation and is an uncommon type of benign breast tumor. CASE REPORT Our study reviews the current published literature regarding the combination of these 2 rare neoplasms of the breast and shows a rare case of a 48-year-old woman with a combination of adenoid cystic carcinoma and adenomyoepithelioma. CONCLUSIONS The combination of adenoid cystic carcinoma and adenomyoepithelioma should be part of the differential diagnosis in breast cancer. More research is needed regarding the optimal therapy, which is currently surgical excision.
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Affiliation(s)
- Antigoni Spyrou
- Department of General Surgery, Agios Dimitrios General Hospital, Thessaloniki, Greece
| | | | - Dimitrios Chytas
- Department of Anatomy, National School of Public Health, University of West Attica, Athens, Greece
| | - George Komsis
- School of Physical Education and Sports Sciences of Serres, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Iosif Chatzis
- Department of General Surgery, Agios Dimitrios General Hospital, Thessaloniki, Greece
| | | | | | - George Noussios
- School of Physical Education and Sports Sciences of Serres, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Oda G, Nakagawa T, Mori M, Fujioka T, Onishi I. Adenomyoepithelioma of the breast with malignant transformation and repeated local recurrence: A case report. World J Clin Cases 2021; 9:8864-8870. [PMID: 34734068 PMCID: PMC8546822 DOI: 10.12998/wjcc.v9.i29.8864] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 07/05/2021] [Accepted: 08/23/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Adenomyoepithelioma (AME) of the breast is a rare type of benign breast tumor. Many AMEs show benign behavior, but reports of the malignant type are rare. We present the case of a patient with AME with repeated local recurrences and further malignant transformation.
CASE SUMMARY A 53-year-old woman visited our hospital with a 16-mm palpable mass in the right breast. A core needle biopsy was performed. The pathological diagnosis was AME. Lumpectomy with a safety margin was performed without axillary lymph node dissection (ALND). Two years later, local recurrence developed, and the patient again underwent lumpectomy with a safety margin. The pathology showed malignant AME, and the margin was negative. Eight months later, local recurrence developed again in the same location, and a total mastectomy was performed without ALND. The pathological diagnosis was malignant AME. The patient was disease-free for three years posttreatment.
CONCLUSION The treatment of AME requires caution, as it may exhibit repeated recurrences after local excision as well as malignant transformation.
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Affiliation(s)
- Goshi Oda
- Department of Breast Surgery, Tokyo Medical and Dental University, Tokyo 113-8519, Japan
| | - Tsuyoshi Nakagawa
- Department of Breast Surgery, Tokyo Medical and Dental University, Tokyo 113-8519, Japan
| | - Mio Mori
- Department of Radiology, Tokyo Medical and Dental University, Tokyo 113-8519, Japan
| | - Tomoyuki Fujioka
- Department of Radiology, Tokyo Medical and Dental University, Tokyo 113-8519, Japan
| | - Iichiro Onishi
- Department of Pathology, Tokyo Medical and Dental University, Tokyo 113-8519, Japan
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Parikh P, Jameel Z, Falcon S, Rosa M, Kiluk J, Hoover S, Soliman H, Ataya D. Adenomyoepithelioma of the breast: Case series and literature review. Clin Imaging 2021; 75:157-164. [PMID: 33607537 DOI: 10.1016/j.clinimag.2021.02.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 01/11/2021] [Accepted: 02/01/2021] [Indexed: 01/03/2023]
Abstract
Adenomyoepithelioma of the breast is a rare tumor consisting of both epithelial and myoepithelial cells. Malignant transformation of either cell line can occur. We describe the imaging features, clinical presentation, and management of seven cases of biopsy-proven adenomyoepithelioma at our institution.
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Affiliation(s)
- Puja Parikh
- Department of Radiology, University of South Florida, Tampa, FL, USA
| | - Zena Jameel
- Department of Pathology, Division of Breast Pathology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Shannon Falcon
- Department of Radiology, Division of Breast Imaging, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Marilin Rosa
- Department of Pathology, Division of Breast Pathology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - John Kiluk
- Department of Breast Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Susan Hoover
- Department of Breast Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Hatem Soliman
- Department of Breast Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Dana Ataya
- Department of Radiology, Division of Breast Imaging, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA.
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