Pleomorphic Adenoma of the Breast

Abstract

A 59-year-old woman presented with a subareolar mass of the left breast. The lesion was described as firm in consistency; examination with mammography and sonography identified a 2 cm lobulated mass with irregular margins (Figs 1 and 2). Ultrasound-guided fine-needle aspiration (FNA) cytology revealed the presence of laminar aggregates of epithelial elements with elongated and polymorphic nuclei. Other features included the presence of myxoid tissue containing spindle cells and fragments of cartilaginous stroma (Fig. 3a,b). The cytologic diagnosis was benign lesion compatible with mixed tumor.In view of the benign nature of the mass, a local excision was performed. The resection specimen consisted of a fragment of mammary tissue that measured 6 cm × 5 cm × 3 cm and comprised a well-circumscribed 2 cm mass with a pale white color. Histologically the lesion showed a mixture of epithelial cells surrounded by an outer layer of myoepithelial cells; stroma contained cartilaginous and myxoid tissue with spindle and stellate cells (Fig. 3c,d).The epithelial component was arranged as tubular structures and cords of cuboidal cells with small oval nuclei.Knowledge of the occurrence of pleomorphic adenomas in the breast, together with careful assessment of the cytologic features present should avoid the mistaken diagnosis of malignancy and prevent unnecessarily overaggressive surgery. Figure 1. Mammography, left mediolateral oblique view, shows a subareolar mass with lobulated margins.Figure 2. Sonography shows an irregular 2 cm hypoechogenic mass.

Pleomorphic adenoma of the breast

“…[1][2][3][4][5][6][7][8] The mammographic fi ndings have been reported in 11 articles. [9][10][11][12][13][14][15][16][17][18][19] The ultrasonography also has been reported in only 2 articles. 16,19 Because of its extreme rarity in the breast and of imaging fi ndings often suggestive of carcinoma, a correct preoperative diagnosis might be diffi cult.…”

“…[9][10][11][12][13][14][15][16][17][18][19] The ultrasonography also has been reported in only 2 articles. 16,19 Because of its extreme rarity in the breast and of imaging fi ndings often suggestive of carcinoma, a correct preoperative diagnosis might be diffi cult. Many authors have reported that preoperative diagnosis was carcinoma, [9][10][11][12][13] whereas benign tumors were suspected in three cases.…”

“…However, the presence of calcifi cation was not described in many reports concerning pleomorphic adenoma of the breast. [5][6][7][8]11,12,19 Some authors reported that the tumor revealed no calcifi cations on mammography. 10,16,18 On the other hand, calcifi cation was identifi ed in fi ve cases.…”

“…1 The interest in many reports has focused on the histopathology of the tumor and the results of fi ne-needle aspiration. [1][2][3][4][5][6][7][8] Mammographic features were reported without [9][10][11][12] or with [13][14][15][16][17][18][19] images. The tumor is a well-circumscribed, round to ovoid mass, but sometimes shows an irregular shape with many protuberances.…”

Pleomorphic Adenoma of the Breast Should Be Excised with a Cuff of Normal Tissue

“…Pleomorphic adenoma is one such benign tumor found commonly in the salivary glands but rarely in the breast and skin. Seventy‐one cases of pleomorphic adenoma of the breast (PAB) have been reported in literature with two being recurrent (1–6). The correct diagnosis has most often been made postoperatively and in a few cases misdiagnosis as malignancies has resulted in erroneous mastectomies (2).…”