Benign adenomyoepitelioma of the breast: Presentation of two rare cases and review of literature

Adenomyoepithelioma of the Breast: A Case Report

Adenomyoepithelioma (AME) is an uncommon breast tumor distinguished by the presence of both epithelial and myoepithelial cell proliferation. It often presents clinically as a well-circumscribed, non-painful mass, although it can also be asymptomatic and discovered incidentally during imaging. This case report describes a 32-year-old woman with a tumor that progressively increased in size. It was initially assessed as a fibroadenoma based on ultrasonography and MRI, as the patient declined to undergo a core needle biopsy. The tumor poses significant diagnostic challenges due to its diverse imaging characteristics, necessitating a core needle biopsy for initial identification. There is also considerable variability within different regions of the same tumor, and surgical removal is typically recommended for most cases of AME. Most AMEs are benign, but they have the potential for local recurrence after surgical excision and, in rare cases, can become malignant. Accurate diagnosis and appropriate management can be achieved through clinical suspicion during examination, combined with the use of radiological techniques and histopathological analysis.

Benign Adenomyoepithelioma of the Breast: A Case Report

Adenomyoepitheliomas of the breast are rare tumors that are characterized histologically as having both epithelial and myoepithelial components. While adenomyoepitheliomas are considered benign lesions, existing literature supports their potential for malignant transformation. These tumors also exhibit nonspecific and variable findings on noninvasive imaging, posing additional challenges in management. We present a rare case of an adenomyoepithelioma diagnosed in a 65-year-old female who was treated with surgical resection of her tumor, with histopathology negative for malignant transformation. By describing this patient's management course, we aim to contribute to existing literature analyzing adenomyoepitheliomas and help guide future treatment.

A rare case of a recurrent atypical adenomyoepithelial tumor of the breast: Case report

INTRODUCTION

Adenomyoepithelial tumors of the breast are very rare tumors comprising of - fibroepithelial and myoepithelial components PRESENTATION OF THE CASE: We present the case of a 66 years old lady who presented with a right breast lump 5 cm in size, diagnosed as an atypical adenomyoepithelioma who underwent successful excision and returned two and half years later with a recurrence DISCUSSION: These tumors present a diagnostic dilemma needing histopathology for definitive diagnosis. Recurrence is not uncommon CONCLUSION: Adenomyoepitheliomas demand regular surveillance for early detection of any recurrence.

Benign adenomyoepithelioma of the breast: a case report

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.

Adenomyoepithelioma of the breast: a rare diagnosis complicated by surgical emergency and diagnostic uncertainty

A woman in her 80s was referred as an emergency case with a large oedematous and ulcerating lesion of the right breast. There was a 5-month history of increasing breast volume with new onset skin breakdown and discharge. Imaging revealed an extensive heterogeneous mass requiring drainage. No diagnosis was received from multiple biopsies and immediate surgical resection of the breast and axillary sampling was prioritised given the deteriorating patient condition. Postoperative histology identified a biphasic Adenomyoepithelioma of low malignant potential, a rare presentation compounding the complexity of management. The diagnostic uncertainty of this case highlighted the importance of MDT collaboration and the flexibility of current management pathways when dealing with cases requiring urgent surgical intervention. Axillary sampling in the context of unsuccessful preoperative biopsy represented a comprehensive means for assessing the need for further surgical or systemic management in the context of unconfirmed malignancy in a deteriorating patient.

Profile of Histopathological Type and Molecular Subtypes of Mammary Cancer of DMBA-induced Rat and its Relevancy to Human Breast Cancer

BACKGROUND: Animal models with mammary cancer that closely mimic human breast cancer for treatment development purposes are still required. Induction of 7,12-dimethylbenzanthracene (DMBA) to rats shows the histopathological features and mammary cancer characterization similar to humans. Examinations of estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2), and Ki67 expressions are crucial in deciding the treatment and prognosis of breast cancer. AIM: This research aimed to view histopathology images of mammary glands and expressions of ER, PR, Ki67, and HER2 of DMBA-induced rats. METHODS: After 1-week adaptation, 11 5-weeks-old female rats were induced with 20 mg/kg body weight (BW) of DMBA 2 times a week for 5 weeks. On week 29, nodules taken from the mammary gland were examined for hematoxylin-eosin staining and immunohistochemistry with p63, ER, PR, HER2, and Ki67 antibodies. The grading score used the Nottingham Grading System and molecular classifications based on St. Gallen 2013. RESULTS: Six rats had nodules, but the histopathologic features of one nodule showed normal mammary gland without cancer. The histopathological type of mammary cancer was cribriform carcinoma, comedo carcinoma, lipid-rich carcinoma, adenocarcinoma squamous, and adenomyepithelioma. Histopathological grading showed 60% of grade 3 and 40% of grade 2. P63 expression showed 60% positive and 40% negative. The frequency of ER, PR, HER2, and Ki67 of five nodules showed positivity: 40%, 60%, 60%, and 60%, respectively. Molecular subtypes of Luminal A, B, HER2, and triple-negative were 0%, 60%, 20%, and 20%, respectively. CONCLUSION: Histopathological features and molecular subtype of mammary cancer on rats induced with 20 mg/kg BW of DMBA showed similarity to human breast cancer.

Diagnostic challenges of adenomyoepithelioma: A case report

INTRODUCTION

Breast adenomyoepithelioma is a very uncommon tumor, which is generally considered to be benign, however malignant transformation has been reported.

PRESENTATION OF CASE

We report two cases of two women with breast adenomyoepithelioma.

CONCLUSION

Diagnosis of adenomyoepithelioma is challenging because tumor may mimic other breast diseases. It has neither specific clinical signs nor radiological features, and the diagnosis is based on histopathological examination of the lesion. The treatment of choice is surgery. The type of surgery depends on the tumor factors and breast size. In malignant cases treatment such as radiotherapy, chemotherapy, immunotherapy may be used as well. It is very important to give an adequate treatment, otherwise the risk of tumor recurrence, growth or even metastatic spread, when tumor has malignant potential, increases.

Adenomyoepithelioma of the breast: Case series and literature review

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.

Malignant adenomyoepithelioma of the breast: A case report

RATIONALE

Adenomyoepithelioma (AME) is a rare biphasic tumor consisting of epithelial and Myoepithelial cell. Most of the AME is benign, and only a few will progress to malignancy, Here, we report a case of low-grade malignant adenomyoepithelioma, and review the related literature, in a bid to investigate its clinical and pathological features and thus, enhance our understanding of this tumor.

PATIENT CONCERNS

A 64-year-old woman visited our hospital with a 1-year history of a painless mass in her left breast. Physical examination revealed a palpable painless mass, measuring approximately 4.5 cm, in the left breast.

DIAGNOSIS

Histological examination confirmed the diagnosis of malignant adenomyoepithelioma.

INTERVENTIONS

The patient underwent local excision of the mass, with frozen section analysis revealing ductal carcinoma in situ. Mastectomy and sentinel lymph node biopsy were then performed.

OUTCOMES

We conducted a one-year follow-up, and relapse was not observed.

LESSONS

Treatment of AME remains controversial owing to the lack of high volume data and absence of prospective studies. Simple mastectomy is an acceptable treatment of this tumor.