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Jayakar S, Tiwari S, Sri Sai Teja Sampath K, Singh G, Badangi V. Adenomyoepithelioma: A Case Report of a Rare Breast Lump. Cureus 2024; 16:e62931. [PMID: 39050335 PMCID: PMC11265964 DOI: 10.7759/cureus.62931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Accepted: 06/22/2024] [Indexed: 07/27/2024] Open
Abstract
Adenomyoepithelioma (AME) of the breast is a rare tumor characterized by biphasic differentiation into luminal and myoepithelial cells, with various histological patterns observed. This case report details a 35-year-old female with a progressively enlarging breast lump diagnosed initially as a fibroadenoma through ultrasonography (USG) and fine-needle aspiration cytology (FNAC). The patient underwent successful excision of the lump under general anesthesia, with histopathological examination confirming a benign tumor comprising epithelial and myoepithelial cells. This case underscores the importance of comprehensive clinical assessment and accurate diagnostic techniques in managing breast lumps, emphasizing the need for timely intervention for favorable outcomes.
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Affiliation(s)
- Sudhir Jayakar
- General Surgery, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth (Deemed to be University), Pune, IND
| | - Siddharth Tiwari
- General Surgery, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth (Deemed to be University), Pune, IND
| | - Kondapalli Sri Sai Teja Sampath
- General Surgery, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth (Deemed to be University), Pune, IND
| | - Guneet Singh
- General Surgery, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth (Deemed to be University), Pune, IND
| | - Vinay Badangi
- General Surgery, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth (Deemed to be University), Pune, IND
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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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Hu L, Qian B, Yan Z, Bing K, Mei L, Qu X. Case report and literature review: Malignant adenomyoepithelioma after breast augmentation. Front Surg 2022; 9:981045. [PMID: 36311924 PMCID: PMC9606651 DOI: 10.3389/fsurg.2022.981045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 09/15/2022] [Indexed: 11/07/2022] Open
Abstract
Background Breast malignant adenomyoepithelioma (MAME) after breast augmentation has never been reported. Case summary We reported a case of a 55-year-old woman who was diagnosed with breast MAME 16 years after breast augmentation. Breast augmentation was performed on the patient with two 200 ml round textured prostheses in the subpectoral plane through axillary incisions in 2004. However, a breast ultrasound in 2020 revealed a suspicious malignant lump in the right breast, which was finally confirmed as MAME by pathology. Skin-sparing modified radical mastectomy and immediate breast reconstruction with expander implantation were performed. Subsequently, the patient received three cycles of chemotherapy with the regimen of anthracycline and cyclophosphamide. In the following nearly 2 years of follow-up, no tumor recurrence and metastasis were found, and the overall treatment was satisfactory for the patient. Conclusion Here, we present a unique case in which a patient was diagnosed with breast MAME after breast augmentation. Skin-sparing modified radical mastectomy and immediate breast reconstruction with expander implantation are feasible approaches that yield at least short-term oncological safety and acceptable aesthetic results. However, whether there is a potential relationship between MAME and breast implants remains to be further explored. Meanwhile, due to the rarity of breast MAME, more authoritative strategies considering both oncological safety and aesthetics to seek better long-term therapeutic effects are needed.
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Affiliation(s)
- Longqing Hu
- Department of Thyroid and Breast Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Bei Qian
- Department of Thyroid and Breast Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhecheng Yan
- Department of Pathology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Kaijian Bing
- Department of Thyroid and Breast Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Li Mei
- Department of Thyroid and Breast Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China,Correspondence: Li Mei Xincai Qu
| | - Xincai Qu
- Department of Thyroid and Breast Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China,Correspondence: Li Mei Xincai Qu
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Nunes M, Garcia A, Nakagaki K, Cassali G. Histopathological and immunohistochemical characteristics of malignant adenomyoepithelioma in a cat: case report. ARQ BRAS MED VET ZOO 2021. [DOI: 10.1590/1678-4162-12312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT The malignant adenomyoepithelioma is a rare mammary tumor in women and uncommon in cats with only one report in this species. In this case report, the histopathological and immunohistochemical characteristics of six cases of malignant adenomyopithelioma in the feline mammary gland are described. Microscopic evaluation of tumors showed dense cellular neoplastic proliferation, composed of malignant myoepithelial and epithelial cells, formed by varied arrangements and presenting papillary, tubular and solid nest proliferation. Immunohistochemistry was performed for markers Ki67, Cox-2, RE, RP, p63 and HER-2. All cases were positive for p63, confirming the myoepithelial nature of neoplastic cells. The diagnosis of malignant adenomyopithelioma was made possible through the association between histopathological characteristics and immunohistochemical results.
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Affiliation(s)
- M.M. Nunes
- Universidade Federal de Minas Gerais, Brazil
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Zhai DY, Zhen TT, Zhang XL, Luo J, Shi HJ, Shi YW, Shao N. Malignant adenomyoepithelioma of the breast: Two case reports and review of the literature. World J Clin Cases 2021; 9:9549-9556. [PMID: 34877289 PMCID: PMC8610870 DOI: 10.12998/wjcc.v9.i31.9549] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 07/27/2021] [Accepted: 09/08/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Malignant adenomyoepithelioma (AME) of the breast is a rare tumor in which malignancy can arise from either epithelial or myoepithelial components, or from both cell types. The incidence and prognosis of malignant AME of the breast are difficult to assess due to its rarity. Therefore, the optimal treatment for this disease is still controversial.
CASE SUMMARY We present two middle-aged women (48 and 56 years old) with malignant AME of the breast. Core needle biopsy was performed before surgery. However, breast adenoma and malignant tumors were observed. The preoperative diagnosis of malignant AME of the breast is still challenging for pathologists and clinicians. Both patients underwent mastectomy and sentinel lymph node biopsy, both of which were negative, followed by adjuvant chemotherapy.
CONCLUSION The follow-up duration of the two patients was two years and four months, respectively. No signs of relapse or metastasis have been observed thus far.
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Affiliation(s)
- Duan-Yang Zhai
- The Breast Disease Center, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510000, Guangdong Province, China
| | - Tian-Tian Zhen
- Department of Pathology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510000, Guangdong Province, China
| | - Xiao-Ling Zhang
- Department of Radiology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510000, Guangdong Province, China
| | - Jia Luo
- Department of Medical Ultrasonics, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510000, Guangdong Province, China
| | - Hui-Juan Shi
- Department of Pathology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510000, Guangdong Province, China
| | - Ya-Wei Shi
- The Breast Disease Center, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510000, Guangdong Province, China
| | - Nan Shao
- The Breast Disease Center, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510000, Guangdong Province, China
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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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Zhang Z, Wang Y, Xie X, Peng J, Hong J, Bi L, Yang M. Malignant adenomyoepithelioma of the breast: A case report. Medicine (Baltimore) 2021; 100:e24461. [PMID: 33592899 PMCID: PMC7870234 DOI: 10.1097/md.0000000000024461] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 01/06/2021] [Indexed: 02/07/2023] Open
Abstract
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.
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Affiliation(s)
| | | | | | | | | | - Lirong Bi
- Department of Pathology, First Hospital of Jilin University, Changchun, People's Republic of China
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Adenomyoepithelial tumors of the breast: molecular underpinnings of a rare entity. Mod Pathol 2020; 33:1764-1772. [PMID: 32355271 DOI: 10.1038/s41379-020-0552-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2020] [Revised: 04/07/2020] [Accepted: 04/07/2020] [Indexed: 02/07/2023]
Abstract
Adenomyoepitheliomas (AMEs) of the breast are uncommon and span the morphologic spectrum of benign, atypical, in situ, and invasive forms. In exceptionally rare cases, these tumors metastasize to regional lymph nodes or distant sites. In the era of genomic characterization, data is limited regarding AMEs. The aim of this study was to provide insight into the molecular underpinnings of a spectrum of AMEs. Seven cases of AMEs of the breast (benign-1, atypical-2, in situ-1, invasive-3) were identified in our files. The seven samples were interrogated using the Oncomine Comprehensive Assay v3 (ThermoFisher). Two atypical AMEs and the malignant in situ AME harbored the same gain-of-function PIK3CA mutation. The malignant in situ AME also showed EGFR amplification, not described previously. Both a benign AME and a malignant invasive AME shared the same gain-of-function AKT1 variant. The benign AME also showed a GNAS mutation. Moreover, the same gain-of-function HRAS mutation was present in an atypical AME and a malignant invasive AME. We also identified co-occurring HRAS and PIK3CA mutations in an ER-positive atypical AME, which has not been previously described. No fusion drivers were detected. We describe the molecular characteristics of the spectrum of AME tumors of the breast, which harbor alterations in the PI3K/AKT pathway. Our findings are clinically relevant with respect to the current options of targeted therapy in the rare instances where malignant AME tumors of the breast progress.
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Moro K, Sakata E, Nakahara A, Hashidate H, Gabriel E, Makino H. Malignant adenomyoepithelioma of the breast. Surg Case Rep 2020; 6:118. [PMID: 32472226 PMCID: PMC7260303 DOI: 10.1186/s40792-020-00881-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Accepted: 05/21/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Adenomyoepithelioma (AME) of the breast is a very rare tumor and is generally considered to be benign. However, some show malignant transformation, which results in local recurrences or distant metastases. The morphological features of AME that might predict malignant potential have not been elucidated. Moreover, there is also no established multidisciplinary treatment for malignant AME aside from complete excision at an early stage. CASE PRESENTATION A 64-year-old female diagnosed with AME of the left breast underwent lumpectomy. The surgical margins were negative. Six months after the operation, however, malignant AME recurred locally in the left breast. MRI showed multiple masses, which invaded the skin. A left mastectomy with axillary lymph node dissection was performed. Additional areas of AME were found in about one third of the entire breast. Eight months after the mastectomy, lung metastases were detected. She underwent chemotherapy with fluorouracil, epirubicin, and cyclophosphamide (FEC) for 9 cycles with little response. Lung metastasectomy was performed. Nine months after lung metastasectomy, the metastases were widespread to the brain, heart, and kidney; she subsequently died 2 months later. CONCLUSIONS Malignant AME has various morphological features, and in this report, we characterize new findings from both imaging and pathology/autopsy. Malignant potency is related to the tumor size, tumor appearance, and mitoses, even if only a few. Given that ductal spread is one of the morphological features of malignant AME, it is of paramount importance to assess the surgical margins.
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Affiliation(s)
- Kazuki Moro
- Department of Breast Surgery, Niigata City General Hospital, 463-7 Shumoku, Chuo-ku, Niigata, 950-1197, Japan.
| | - Eiko Sakata
- Department of Breast Surgery, Niigata City General Hospital, 463-7 Shumoku, Chuo-ku, Niigata, 950-1197, Japan
| | - Asa Nakahara
- Department of Pathology, Niigata City General Hospital, 463-7 Shumoku, Chuo-ku, Niigata, 950-1197, Japan.,Department of Pathology, Brain Research Institute, Niigata University, Niigata City, 950-8585, Japan
| | - Hideki Hashidate
- Department of Pathology, Niigata City General Hospital, 463-7 Shumoku, Chuo-ku, Niigata, 950-1197, Japan
| | - Emmanuel Gabriel
- Department of Surgery, Mayo Clinic, Jacksonville, FL, 32224, USA
| | - Haruhiko Makino
- Department of Breast Surgery, Niigata City General Hospital, 463-7 Shumoku, Chuo-ku, Niigata, 950-1197, Japan.,Makino Breast Clinic, Niigata, 950-0861, Japan
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Haque W, Verma V, Suzanne Klimberg V, Nangia J, Schwartz M, Brian Butler E, Teh BS. Clinical presentation, national practice patterns, and outcomes of breast adenomyoepithelioma. Breast J 2019; 26:653-660. [DOI: 10.1111/tbj.13638] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2019] [Revised: 09/06/2019] [Accepted: 09/06/2019] [Indexed: 12/20/2022]
Affiliation(s)
- Waqar Haque
- Department of Radiation Oncology Houston Methodist Hospital Houston TX USA
| | - Vivek Verma
- Department of Radiation Oncology Allegheny General Hospital Pittsburgh PA USA
| | | | - Julie Nangia
- Department of Medical Oncology Baylor College of Medicine Houston TX USA
| | - Mary Schwartz
- Department of Pathology Houston Methodist Hospital Houston TX USA
| | | | - Bin S. Teh
- Department of Radiation Oncology Houston Methodist Hospital Houston TX USA
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Gafton B, Scripcariu V, Prutianu I, Alexa-Stratulat T, Terinte C, Nicolau A, Moisiuc D, Radu I. Challenges in management of male breast adenomioepithelioma with malignant behavior: Case report. Medicine (Baltimore) 2019; 98:e17587. [PMID: 31651866 PMCID: PMC6824645 DOI: 10.1097/md.0000000000017587] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
RATIONALE Male adenomyoepithelioma of the breast with malignant features is a rare tumor with only one previous case reported in the literature over 25 years ago. PATIENT CONCERNS We report the case of a 63-year-old man admitted to our Oncology Institute with a painless tumor mass of 6 cm in the left breast with no additional regional lymph nodes. Ultrasound revealed a complex cystic tumor mass of 60 mm in the left breast, with both anechoic (cystic) and echogenic (solid) components, with ill-defined margin. DIAGNOSES Extemporaneous assessment showed a solid (invasive) papillary intracystic carcinoma. Definitive pathology examination revealed the presence of a breast malignant adenomyoepithelioma. INTERVENTIONS Based on the extemporaneous assessment, wide tumor excision was performed. The tumor board decided to continue treatment with adjuvant anthracycline-based chemotherapy. OUTCOMES After 6 years of follow-up, the patient is cancer-free. No chronic side effects were noted. LESSONS Because this pathology is extremely rare, no guidelines are available for its therapeutic approach. All decisions regarding patient management should be made by a multi-disciplinary team and can only be based on clinical experience and the few cases reported in female patients.
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Affiliation(s)
- Bogdan Gafton
- “Grigore T. Popa” University of Medicine and Pharmacy Iaşi
| | | | | | | | | | - Andrei Nicolau
- “Grigore T. Popa” University of Medicine and Pharmacy Iaşi
| | - Diana Moisiuc
- “Grigore T. Popa” University of Medicine and Pharmacy Iaşi
| | - Iulian Radu
- “Grigore T. Popa” University of Medicine and Pharmacy Iaşi
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Watanabe S, Otani T, Iwasa T, Takahama T, Takeda M, Sakai K, Nishio K, Ito A, Nakagawa K. A Case of Metastatic Malignant Breast Adenomyoepithelioma With a Codon-61 Mutation of HRAS. Clin Breast Cancer 2019; 19:e589-e592. [PMID: 31301988 DOI: 10.1016/j.clbc.2019.05.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Revised: 05/02/2019] [Accepted: 05/07/2019] [Indexed: 02/01/2023]
Affiliation(s)
- Satomi Watanabe
- Department of Medical Oncology, Kindai University Faculty of Medicine, Osaka, Japan
| | - Tomoyuki Otani
- Department of Pathology, Kindai University Faculty of Medicine, Osaka, Japan
| | - Tsutomu Iwasa
- Department of Medical Oncology, Kindai University Faculty of Medicine, Osaka, Japan.
| | - Takayuki Takahama
- Department of Medical Oncology, Kindai University Faculty of Medicine, Osaka, Japan
| | - Masayuki Takeda
- Department of Medical Oncology, Kindai University Faculty of Medicine, Osaka, Japan
| | - Kazuko Sakai
- Department of Genome Biology, Kindai University Faculty of Medicine, Osaka, Japan
| | - Kazuto Nishio
- Department of Genome Biology, Kindai University Faculty of Medicine, Osaka, Japan
| | - Akihiko Ito
- Department of Pathology, Kindai University Faculty of Medicine, Osaka, Japan
| | - Kazuhiko Nakagawa
- Department of Medical Oncology, Kindai University Faculty of Medicine, Osaka, Japan
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Zhu J, Li K, Dong X, Zhou P, Li P, Bi J. Metaplastic breast carcinoma composed of epithelial-myoepithelial carcinoma and squamous cell carcinoma: A case report. Medicine (Baltimore) 2018; 97:e0364. [PMID: 29642184 PMCID: PMC5908572 DOI: 10.1097/md.0000000000010364] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
RATIONALE Metaplastic breast carcinomas are a group of breast malignancies with varying histomorphological characteristics and prognoses. The tumor composed of epithelial -myoepithelial carcinoma and squamous cell carcinoma was not reported previously. PATIENT CONCERNS An 81-year-old woman presented with a palpable nodule in the left breast for 4 days. The ultrasonography showed multinodular growth and focally indistinct borders. Owing to her advanced age and possible early clinical staging, primary tumor resection was performed. One year later, a small and slow growing subcutaneous nodule was found under the incision of the left breast. Ultrasonography revealed an irregular, cystic and solid, hypoechoic mass with circumscribed borders. DIAGNOSES Microscopic examination of the primary tumor revealed epithelial -myoepithelial carcinoma and squamous cell carcinoma. The former had a variety of architecture patterns, including nests, lobulations, papillary and tubular structures, and the latter showed varying morphological features, from squamous pearls to spindle cells. The recurrent tumor showed only epithelial -myoepithelial carcinoma with more aggressively malignant features than those seen in the primary tumor. INTERVENTIONS An extensive resection of the left breast mass was performed for the recurrent tumor. The patient did not receive any adjuvant chemotherapy or radiation therapy because of the patient's advanced age. OUTCOMES The patient has been followed up for 1.5 years after second surgery without evidence of tumor recurrence and metastasis. LESSONS Wide local excision with adequate margins is recommended for elderly patients with metaplastic breast carcinoma composed of epithelial -myoepithelial carcinoma and squamous cell carcinoma.
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Affiliation(s)
- Jian Zhu
- Department of Thyroid and Breast Surgery
| | - Kainan Li
- Department of Oncology
- Department of Oncology, Shandong Provincial Third Hospital, Jinan, China
| | | | - Peng Zhou
- Department of Thyroid and Breast Surgery
| | - Peifeng Li
- Department of Pathology, General Hospital of Jinan Military Command
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Díaz Del Arco C, Estrada Muñoz L, Pascual Martín A, Pelayo Alarcón A, de Pablo Velasco D, Ortega Medina L. [Adenomyoepithelioma of the breast: Report of four cases and literature review]. REVISTA ESPAÑOLA DE PATOLOGÍA : PUBLICACIÓN OFICIAL DE LA SOCIEDAD ESPAÑOLA DE ANATOMÍA PATOLÓGICA Y DE LA SOCIEDAD ESPAÑOLA DE CITOLOGÍA 2018; 51:55-60. [PMID: 29290325 DOI: 10.1016/j.patol.2016.12.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Revised: 11/22/2016] [Accepted: 12/02/2016] [Indexed: 12/27/2022]
Abstract
Adenomyoepitheliomas of the breast are infrequent tumors with a variable histological appearance, and they can mimic several epithelial, myoepithelial and biphasic lesions of the breast. We have reviewed four cases of adenomyoepithelioma of the breast diagnosed between 2005 and 2015 in our institution (Hospital Clínico San Carlos). Mean age was 57years. All lesions were solid irregular masses located in the upper quadrants (3 of them in the right breast and one in the left), with an average size of 13mm. Microscopically 2 of them were tubular and the remaining 2 were lobulated subtypes. Hyaline, myxoid and cystic areas, peripheral pseudoinfiltration and satellite nodules were occasionally seen. Myoepithelial cells were fusiform and immunohistochemically they were actin, calponin, p63, S100 and CD10 positive and CKAE1-AE3 negative, with variable CK23BE12 and CK5/6 staining. In all cases lumpectomy was curative, no recurrences or malignant degeneration were observed.
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Logie N, Hugh J, Paulson K, Pearcey R, King KM. Radiotherapy in the Multidisciplinary Management of Adenomyoepithelioma of the Breast with an Axillary Lymph Node Metastasis: A Case Report and Review of the Literature. Cureus 2017; 9:e1380. [PMID: 28775920 PMCID: PMC5522019 DOI: 10.7759/cureus.1380] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
We describe a case of aggressive adenomyoepithelioma (AME) of the breast with a lymph node metastasis. A 63-year-old female presented with a fluctuating breast mass and clinically palpable lymph nodes. The patient underwent excisional biopsy followed by mastectomy with lymph node dissection and adjuvant radiotherapy (RT). Clinical behavior of both benign and malignant AME is described with the review of the literature and treatment recommendations.
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Affiliation(s)
| | - Judith Hugh
- Division of Anatomical Pathology, University of Alberta
| | - K Paulson
- Radiation Oncology, University of Alberta
| | | | - Karen M King
- Department of Medical Oncology, Cross Cancer Institute, University of Alberta
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Korolczuk A, Amarowicz M, Bąk K, Korobowicz E, Koncewicz T. Adenomyoepithelioma of the breast with late pulmonary metastases - case report and review of the literature. J Cardiothorac Surg 2016; 11:121. [PMID: 27487934 PMCID: PMC4973092 DOI: 10.1186/s13019-016-0518-8] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2016] [Accepted: 07/27/2016] [Indexed: 02/07/2023] Open
Abstract
Background Adenomyoepithelioma (AME) of the breast is a rare tumour of unpredictable clinical behaviour. Most of the tumours are benign with some giving local recurrences or distant metastases. Case Presentation We report a case of late lung metastases in a woman with a history of breast adenomyoepithelioma. Partial lobectomy was performed for lung lesions and initial diagnosis was epithelial-myoepithelial carcinoma. Conclusion Careful slide’s revision of both breast and pulmonary lesions showed identical microscopic appearance with lung tumour performing more malignant features. Tumour cells in both: breast and pulmonary lesions were positive for cytokeratin and EMA (epithelial cells) and also for SMA, S100 and vimentin (myoepithelial cells). Two years and 7 months follow-up showed no recurrent neoplastic disease in our patient.
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Affiliation(s)
- Agnieszka Korolczuk
- Department of Clinical Pathomorphology, Medical University, Jaczewskiego 8, 20-059, Lublin, Poland.
| | - Magdalena Amarowicz
- Department of Clinical Pathomorphology, Medical University, Jaczewskiego 8, 20-059, Lublin, Poland
| | - Kamila Bąk
- Department of Clinical Pathomorphology, Medical University, Jaczewskiego 8, 20-059, Lublin, Poland
| | - Elżbieta Korobowicz
- Department of Clinical Pathomorphology, Medical University, Jaczewskiego 8, 20-059, Lublin, Poland
| | - Tomasz Koncewicz
- Chair and Department of Thoracic Surgery, Medical University, Lublin, Poland
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