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Kaki M, Klein S, Singh C, Kothe B, Martin J. An Immunohistochemical Anomaly: A Case Report and Systematic Review of Myofibroblastoma of the Breast. Cureus 2023; 15:e46125. [PMID: 37900540 PMCID: PMC10612385 DOI: 10.7759/cureus.46125] [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: 08/22/2023] [Accepted: 09/28/2023] [Indexed: 10/31/2023] Open
Abstract
Myofibroblastoma (MFB) is a rare but benign mesenchymal tumor most commonly appearing within breast tissue. Most cases of MFB occur in postmenopausal women and are treated by surgical excision. The diagnosis of MFB is made through immunohistochemical (IHC) analysis, with the most common biomarkers being CD34+, desmin+, smooth muscle actin+, and vimentin+. In this article, we describe a case of an MFB in a premenopausal female with variance from classic IHC findings. We also performed a systemic review of the MFB of the breast. The systemic review compiles the most common IHC findings of MFB, patient demographics, treatment methods, lesion size, and the presence or absence of pain associated with the lesion. As MFB can share many features with other breast lesions, including potentially malignant ones, this article sought to underline the most common IHC findings and characteristics of MFB to aid in the proper diagnosis of MFB.
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Affiliation(s)
- Mohamad Kaki
- Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Davie, USA
| | - Sarah Klein
- Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Clearwater, USA
| | - Chinar Singh
- Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, USA
| | - Breanne Kothe
- Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, USA
| | - Jose Martin
- General Surgery, Broward Health, Tamarac, USA
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Yang GZ, Liang SH, Shi XH. A novel collision tumour of myofibroblastoma and low-grade adenosquamous carcinoma in breast. Diagn Pathol 2020; 15:76. [PMID: 32576221 PMCID: PMC7313209 DOI: 10.1186/s13000-020-00992-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 06/17/2020] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND Myofibroblastoma (MFB) and low-grade adenosquamous carcinoma (LGASC) are rare tumours in the breast, respectively. However, a collision tumour of the two types has never been reported. CASE PRESENTATION A 42-year-old female presented with a palpable mass in diameter of about 2.5 cm in the left breast. Morphologically, the lesion was predominately composed of bland spindle cells admixed with some islands of mature adipocytes and a few epithelial elements dispersing in infiltrating way which formed both tubule and solid structures. The mass showed low positive index of Ki-67. The spindle cells were strongly and diffusely positive for CD34, SMA, desmin, ER and PR. The epithelial elements were positive for CK and EMA, and negative for ER and PR completely. CK5/6 and P63 were positive in the outer-layer of the tubules and nearly all the cells of the solid nests. CONCLUSIONS A collision tumour of MFB and LGASC in breast is extremely rare and either component is supposed to be not overlooked. Excision and close follow-up are advised.
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Affiliation(s)
- Guang-Zhi Yang
- Department of Pathology, Beijing Dian Medical Test Laboratory Co. Ltd, No. 9 Tianfu Street, Daxing District, 102600, Beijing, People's Republic of China.
| | - Shang-Hua Liang
- Department of Pathology, Beijing Dian Medical Test Laboratory Co. Ltd, No. 9 Tianfu Street, Daxing District, 102600, Beijing, People's Republic of China
| | - Xiao-Hong Shi
- Department of Pathology, Beijing Dian Medical Test Laboratory Co. Ltd, No. 9 Tianfu Street, Daxing District, 102600, Beijing, People's Republic of China
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Bonacho T, Rodrigues F, Liberal J. Immunohistochemistry for diagnosis and prognosis of breast cancer: a review. Biotech Histochem 2019; 95:71-91. [PMID: 31502889 DOI: 10.1080/10520295.2019.1651901] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Breast cancer is the most prevalent malignant tumor and main oncologic cause of mortality in women. Although most diagnosis of breast pathology is accomplished using hematoxylin and eosin stained sections, some cases require immunohistochemistry for proper evaluation. We investigated the latter cases including distinctions between ductal and lobular carcinoma, in situ and invasive carcinoma, typical ductal hyperplasia and atypical ductal hyperplasia/ductal carcinoma in situ, papillary and spindle cell lesion assessment, metastasis evaluation, and assessment of prognostic and therapy markers. E-cadherin is used to differentiate ductal and lobular carcinoma; 34βE12, CK8, p120 catenin and β-catenin also produce consistent results. Myoepithelial cell (MEC) stains are used to evaluate in situ and invasive carcinoma; calponin, smooth muscle myosin heavy chain and p63 are sensitive/specific markers. 34βE12 and CK5/6 are positive in ductal hyperplasia, which enables its differentiation from atypical ductal hyperplasia and ductal carcinoma in situ. CK 5/6, ER and MEC markers are consistent options for evaluating papillary lesions. Spindle cell lesions can be assessed using β-catenin, SMA, CD34, p63, CKs and hormone receptors. It is important to differentiate primary carcinomas from metastases; the most commonly used markers to identify breast origin include mammaglobin, GCDFP-15, GATA3 and ER, although none of these is completely sensitive or specific. Immunohistochemistry can be used to evaluate central prognostic and predictive factors including molecular subtypes, HER2, hormone receptors, proliferation markers (Ki-67) and lymph-vascular invasion markers including ERG, CD31, CD34, factor VIII and podoplanin. Owing to the complexity of mammary lesions, diagnosis also depends on each particular situation, evaluation of cytological characteristics revealed by immunochemistry and correlation with histological findings.
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Affiliation(s)
- T Bonacho
- Escola Superior de Saúde Dr. Lopes Dias, Instituto Politécnico de Castelo Branco, Castelo Branco, Portugal
| | - F Rodrigues
- Escola Superior de Saúde Dr. Lopes Dias, Instituto Politécnico de Castelo Branco, Castelo Branco, Portugal.,Qualidade de Vida no Mundo Rural (QRural), Instituto Politécnico de Castelo Branco, Castelo Branco, Portugal.,Sport, Health & Exercise Unit (SHERU), Instituto Politécnico de Castelo Branco, Castelo Branco, Portugal
| | - J Liberal
- Escola Superior de Saúde Dr. Lopes Dias, Instituto Politécnico de Castelo Branco, Castelo Branco, Portugal.,Qualidade de Vida no Mundo Rural (QRural), Instituto Politécnico de Castelo Branco, Castelo Branco, Portugal
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Allahverdi TD, Allahverdi E. Myofibroblastoma. THE JOURNAL OF BREAST HEALTH 2017; 13:100-102. [PMID: 31244537 DOI: 10.5152/tjbh.2017.3232] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Accepted: 12/14/2016] [Indexed: 11/22/2022]
Abstract
Myofibroblastoma of the breast is a rare benign mesenchymal tumor. We report a 61-year-old male case who presented to the orthopedic clinic with right shoulder pain. The physical and clinical examination was normal and he was referred to our clinic. Excision was performed and there were no postoperative complications.
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Affiliation(s)
| | - Ertuğrul Allahverdi
- Department of Orthopedics and Traumatology, Kafkas University School of Medicine, Kars, Turkey
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Sevim Y, Kocaay AF, Eker T, Celasin H, Karabork A, Erden E, Genc V. Breast hamartoma: a clinicopathologic analysis of 27 cases and a literature review. Clinics (Sao Paulo) 2014; 69:515-23. [PMID: 25141109 PMCID: PMC4129555 DOI: 10.6061/clinics/2014(08)03] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2013] [Accepted: 02/04/2014] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES Breast hamartoma is an uncommon breast tumor that accounts for approximately 4.8% of all benign breast masses. The pathogenesis is still poorly understood and breast hamartoma is not a well-known disorder, so its diagnosis is underestimated by clinicians and pathologists. This study was designed to present our experience with breast hamartoma, along with a literature review. METHOD We reviewed the demographic data, pathologic analyses and imaging and results of patients diagnosed with breast hamartoma between December 2003 and September 2013. RESULTS In total, 27 cases of breast hamartoma operated in the Ankara University Medicine Faculty's Department of General Surgery were included in the study. All patients were female and the mean age was 41.8±10.8 years. The mean tumor size was 3.9±2.7 cm. Breast ultrasound was performed on all patients before surgery. The most common additional lesion was epithelial hyperplasia (22.2%). Furthermore, lobular carcinoma in situ was identified in one case and invasive ductal carcinoma was observed in another case. Immunohistochemical staining revealed myoid hamartoma in one case (3.7%). CONCLUSION Breast hamartomas are rare benign lesions that may be underdiagnosed because of the categorization of hamartomas as fibroadenomas by pathologists. Pathologic examinations can show variability from one case to another. Thus, the true incidence may be higher than the literature indicates.
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Affiliation(s)
- Yusuf Sevim
- Department of General Surgery, Ankara Penal Institution Campus State Hospital, Ankara, Turkey
| | - Akin Firat Kocaay
- Department of General Surgery, Ankara University Medical School, Ankara, Turkey
| | - Tevfik Eker
- Department of General Surgery, Ankara University Medical School, Ankara, Turkey
| | - Haydar Celasin
- Department of General Surgery, Ankara Kavakl?dere Umut Private Hospital, Ankara, Turkey
| | - Ayca Karabork
- Department of Pathology, Ankara University Medical School, Ankara, Turkey
| | - Esra Erden
- Department of Pathology, Ankara University Medical School, Ankara, Turkey
| | - Volkan Genc
- Department of General Surgery, Ankara University Medical School, Ankara, Turkey
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Myofibroblastoma of the female breast with admixed but distinct foci of spindle cell lipoma: a case report. Case Rep Pathol 2013; 2013:738014. [PMID: 24459597 PMCID: PMC3891609 DOI: 10.1155/2013/738014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2013] [Accepted: 11/20/2013] [Indexed: 11/26/2022] Open
Abstract
Mammary myofibroblastoma (MFB) is a rare benign spindle neoplasm that affects both sexes with a male predominance. It can exhibit a wide range of histological patterns. We report a case of epithelioid/spindle MFB of the female breast with admixed, but distinct, foci of spindle cell lipoma. Whilst all the spindle cells within the tumour expressed CD34, AR, ER, BCL2, and CD10, only those within the myofibroblastoma expressed desmin and only those within the lipomatous areas expressed S100. This finding, to our knowledge, is a novel one that has not been reported before.
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Gurzu S, Jung I. Male breast cellular myofibroblastoma with a rich reticulinic network: case report. Am J Mens Health 2012; 6:344-8. [PMID: 22433657 DOI: 10.1177/1557988312441817] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Myofibroblastoma is a rare mesenchymal tumor located not only in breast but also in extramammary sites. This is the 79th case of breast myofibroblastoma reported in the literature. This tumor presents a great variety of morphological features, which increase the difficulty of differential diagnosis. The authors report a breast myofibroblastoma diagnosed in a 73-year-old male. The article discusses a bilateral gynecomastia and a palpable right breast well-defined tumor, without calcifications on mammography, which was surgically removed. Macroscopically, a well-circumscribed uncapsulated nodule was seen with lobular arrangement on cut section, and microscopically, a nodule with pushing borders and a connective pseudocapsule was seen. The spindle cells were arranged in fascicular clusters, with focally collagen bundles and a rich reticulinic network stained black with Gömöri impregnation. Immunohistochemically, the tumor cells were marked by vimentin, CD34, desmin, and smooth muscle antigen and did not express cytokeratin, S-100 protein, CD99, CD10, and factor VIII-related antigen. More than 90% of the cells expressed estrogen receptor. No recurrences were reported 2 years after surgical excision. This case is a variant of cellular myofibroblastoma, with a rich reticulinic network and scanty collagen bands.
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Affiliation(s)
- Simona Gurzu
- University of Medicine and Pharmacy, Targu-Mures, Romania.
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