Adenomyoepithelioma with Ductal Carcinoma In Situ: A Case Report and Review of the Literature

Abstract

Adenomyoepithelioma (AME) with microglandular adenosis-like growth pattern and superimposed ductal carcinoma in situ (DCIS) was identified in a 55-year-old female after biopsy of an atypical lesion identified through routine breast screening. A literature review reveals that this association has rarely been described.

Adenomyoepithelioma of the breast with associated atypical lobular hyperplasia: a previously unrecognized association with management implications

“…Various papillary proliferative lesions have been associated with AME [7]. More recently, a case of AME with associated ductal carcinoma in situ has been described in the literature [8]. Contrary to that report, our case illustrates the association of AME with lobular neoplasia, which should lead to different management.…”

“…Malignant transformation can occur involving the epithelial component, the myoepithelial component, or both. Adenomyoepitheliomas must be classified as malignant if they show the occurrence of severe cytologic atypia, high mitotic activity (N3 mitotic features per 10 high-power fields), necrosis, and an infiltrative growth pattern [1,8,11]. The immunohistochemical profile of the glandular cells tends to be strongly reactive with antibodies to cytokeratin, which is localized in cytoplasm and immunoreactive for epithelial membrane antigen at the luminal surfaces.…”

“…While examples of AMEs associated with ductal carcinoma in situ have been previously reported in the literature [8,13], adenomyoepithelioma with ALH or lobular carcinoma in situ (LCIS) has not been previously documented in the literature. This is likely because ALH and LCIS can show a homogenous and monotonous proliferation of cells filling the terminal duct lobular units similar to the myoepithelial cell proliferation in AME.…”

Malignant adenomyoepithelioma combined with adenoid cystic carcinoma of the breast: a case report and literature review

“…Base on the differentiation of the malignancy, the tumors can be divided into monophasic and biphasic. The monophasic malignancy could be invasive ductal carcinoma not otherwise specified, metaplastic carcinoma, low-grade adenosquamous carcinoma [ 5 ], invasive lobular carcinoma [ 7 ], and ductal carcinoma in situ [ 8 , 9 ] which arising from epithelial component, or malignant myoepithelioma [ 1 ] which arising from myoepithelial component. Only 16 biphasic malignant adenomyoepitheliomas in which malignancy arising from both epithelial and myoepithelial cells have been reported previously [ 5 , 6 , 10 – 17 ] (Table 1 ), and our current case is another one.…”

A clinical dilemma: malignant adenomyoepithelioma of the breast – case report and review of literature

“…[15] Based on the differentiation of the malignancy, the tumors can be divided into monophasic and biphasic. The monophasic malignancy could be invasive ductal carcinoma not otherwise specified, metaplastic carcinoma, low-grade adenosquamous carcinoma [7] invasive lobular carcinoma, [16] and ductal carcinoma in situ, [17,18] arising from epithelial component, or malignant myoepithelioma [19] arising from myoepithelial component. Only 16 biphasic malignant AMEs in which malignancy arising from both epithelial and myoepithelial cells have been reported previously.…”