Adenoid cystic carcinoma of the breast with distant metastasis to the liver and spleen: a case report

Abstract

Adenoid cystic carcinoma (ACC) of the breast is a rare malignancy, accounting for 0.1–1% of breast cancers. Histologically breast ACC is similar to ACC’s found in salivary tissue and is a triple-negative breast cancer with an uncharacteristically favorable prognosis and low incidence of metastasis. Most cases present as a painful, palpable mass; however, asymptomatic cases found on screening mammograms have also been noted. Core needle biopsy or excisional biopsy is necessary for definitive diagnosis of breast ACC. Immunohistochemistry of these cancers can differentiate breast ACC from masses with similar histology, such as invasive cribriform carcinoma and collagenous spherulosis. There is no well-established treatment guideline for ACC; however, it has been noted that reoccurrence and metastasis are noted more in cases of local resection than mastectomy.

Adenoid Cystic Carcinoma of the Breast: A Case Report

“…Because the solid histological subtype carries a higher risk of malignancy, they have been further classified into three grades when present in the salivary glands: Grade I has no solid component, Grade II has <30% solid component, and Grade III >30% solid component [ 1 - 5 ]. Our patient’s tumor was the tubular subtype; furthermore, the tumor was also identified to be triple-negative on immunohistochemical analysis, consistent with the majority of breast ACC [ 5 - 8 ]. These tumors exhibit immunoreactivity for p63 and CD17.…”

“…While ACC is a slow-growing tumor, it does exhibit lymphatic spread; therefore, a sentinel lymph node biopsy is an appropriate indicated approach. The patient is triple-negative, therefore, adjuvant therapy with chemotherapy may be discussed on an individualized basis based on comorbidities, size of the tumor, triple-negative status, and subtype of ACC [ 8 ].…”

Adenoid Cystic Carcinoma of the Breast: An Oncological Center's Experience

“…The mainstay of treatment of ACCB has not yet been established due to its rare incidence and indolent behavior, which can be confirmed in the literature, as there are mainly case reports, [7][8][9][10][11] or small series. 2,3,12,13 Regarding histological classification, several scores can be applied.…”