Malignant adenomyoepithelioma of the breast: A rare case report

Kim, Mi Jin; Kim, Cheol Seung; Ju, Myoug Jin; Park, Young Sam

doi:10.1016/j.ijscr.2019.04.045

Cited by 14 publications

(22 citation statements)

References 16 publications

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“…For patients with AME-M, haematogenous spread is more frequently than lymphatic spread, and the need for axillary dissection is unknown [8]. What's more, the need for adjuvant therapy including chemotherapy and/or radiotherapy also remains unclear [9]. In our present case, the patient underwent both sentinel and axillary lymph nodes dissection, and did not observe any lymph node involvement.…”

Section: Discussionmentioning

confidence: 65%

Breast Epithelial-myoepithelial Carcinoma With HER2 Gene Amplification: a Rare Case and Review of Literature

Guo

et al. 2021

Preprint

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Background: Epithelial-myoepithelial carcinoma is a very rare carcinoma that both luminal and myoepithelial components are malignant. What’s more, HER2 gene amplification has not been detected in the literature up to now. Herein, we report a rare case of breast epithelial-myoepithelial carcinoma with HER2 gene amplification.Case presentation: An 80-year-old woman presented with a mass in the upper outside region of her left breast. The core needle biopsy of the left breast mass revealed invasive breast carcinoma, and then modified radical mastectomy of left breast was performed. Macroscopically, the tumor was measured 6cm in diameter, and it was a solid and lobulated mass with areas of cystic and hemorrhagic lesions. Microscopically, the histological findings of tumor were consisted of 3 components. One component showed biphasic proliferation of both eosinophilic luminal epithelial and pale abluminal myoepithelial cells, arranging predominantly in dilated tubular architecture, which accounted for most of the lesion. Papillary architecture and eosinophilic secretions could be seen in some dilated ducts. The second component was proliferation of myoepithelial cells with pale cytoplasm around the glandular epithelium forming casing-like structures. The third component was few solid-appearing areas which was displayed a predominance of monophasic proliferation of myoepithelial cells. Both cell types exhibited enlarged and markedly atypical nuclei, with obvious nucleoli and prominent mitoses (up to 10-15/10 high power fields). Foci of infiltration were identified at the periphery of the lobules and the surrounding adipose tissue. Areas of central necrosis and stromal hyalinization could be seen. A diagnosis of EMC was made by morphology and immunohistochemistry. It's worth noting that HER2 gene amplification has not been detected in malignant adenomyoepitheIioma in the literature up to now; While in our present report, HER2 was 2+ membranous immunoreactivity, and then HER2 gene amplification was detected by fluorescence in situ hybridization. Conclusion: Accurate diagnosis of malignant adenomyoepitheIioma is challenging but of great importance, and the management of malignant adenomyoepitheIioma would be made according to histologic features.

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Section: Discussionmentioning

confidence: 65%

Breast Epithelial-myoepithelial Carcinoma With HER2 Gene Amplification: a Rare Case and Review of Literature

Guo

et al. 2021

Preprint

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“…The diagnosis of AME was established by histopathology and immunohistochemistry. Most of AMEs showed solid mass rather than cystic mass [ 4 ], cystic or prominent cystic changes is extremely rare, in spite of a few may contain small cystic areas [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Adenomyoepithelioma of the breast with prominent cystic changes: a case report

Chen

Liu

et al. 2021

BMC Women's Health

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Background Adenomyoepithelioma (AME) of the breast is a rare subtype of breast tumor. Most of AMEs reported are solid, however, cystic or prominent cystic changes are extremely rare. Case presentation A 51-year-old woman presented a lump in the upper outer quadrant of right breast, and it was accompanied by continuous breast pain and bilateral axillary itching for more than 2 months. There were no other symptoms found. Preoperative mammography and ultrasound examination were performed. Mammography showed a noncalcified lobulated mass, and it was considered to be a benign cyst with septum on ultrasound, but ductal carcinoma of breast, adenoid cystic carcinoma could not be excluded. At first, AME was not considered preoperatively, because the imaging features of this rare tumor may vary widely, which may result in an incorrect diagnosis. But eventually, AME was diagnosed by postoperative pathology and immunohistochemistry. Conclusion We herein present a rare case of breast AME with prominent cystic changes. AME has no-specific imaging features, but the benign or malignant nature of the lesion might be suspected on imaging.

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“…In our case, both of P53 and Ki-67 were high, leading to the observed poor prognosis. There are also no unified views whether hematogenous spread or lymphatic spread occurs in malignant AME, but metastases to the axillary lymph nodes are extremely rare [12]. The pattern of spread in our case suggests that metastatic malignant AME metastasizes mainly through the hematogenous route rather than lymphatic system.…”

Section: Discussionmentioning

confidence: 61%

“…In addition to the tumor size, tumor appearance is an important factor in prognosis. Generally, malignant AME has been described as a large stable mass [12], but In managing the malignant AME, it is important to recognize their poor prognosis. It is known that P53 and Ki-67 are important prognostic factors.…”

Section: Discussionmentioning

confidence: 99%

Malignant adenomyoepithelioma of the breast

et al. 2020

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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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Malignant adenomyoepithelioma of the breast: A rare case report

Cited by 14 publications

References 16 publications

Breast Epithelial-myoepithelial Carcinoma With HER2 Gene Amplification: a Rare Case and Review of Literature

Breast Epithelial-myoepithelial Carcinoma With HER2 Gene Amplification: a Rare Case and Review of Literature

Adenomyoepithelioma of the breast with prominent cystic changes: a case report

Malignant adenomyoepithelioma of the breast

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