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Surgical Case Reports May 2020Adenomyoepithelioma (AME) of the breast is a very rare tumor and is generally considered to be benign. However, some show malignant transformation, which results in...
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.
PubMed: 32472226
DOI: 10.1186/s40792-020-00881-2 -
The Breast Journal 2015Malignant adenomyoepithelioma (MAME) of the breast is a rare lesion characterized by dual population of epithelial and myoepithelial cells which one or both components... (Review)
Review
Malignant adenomyoepithelioma (MAME) of the breast is a rare lesion characterized by dual population of epithelial and myoepithelial cells which one or both components show malignant features. We report a case of MAME of the breast in a 46-year-old woman diagnosed by fine-needle aspiration with extensive review of the literature. Classification, clinical presentation, cyto-pathologic, and immunohistochemical features are described. This lesion showed both malignant components of epithelial and myoepithelial cells in cytology and histology. The malignancy was convincingly supported by high mitotic figures, pleomorphism, and invasion in tissue sections. This review of MAMEs showed that cyto-histologic diagnosis is difficult and should be supported by immunohistochemical study.
Topics: Adenomyoepithelioma; Biopsy, Fine-Needle; Breast Neoplasms; Female; Humans; Immunohistochemistry; Middle Aged
PubMed: 25772218
DOI: 10.1111/tbj.12390 -
Head & Neck Oncology Mar 2010We present a case of adenomyoepithlioma (AME) arising from the tonsil. AME is an uncommon tumor that typically arises in breast, but rarely found in salivary glands,... (Review)
Review
We present a case of adenomyoepithlioma (AME) arising from the tonsil. AME is an uncommon tumor that typically arises in breast, but rarely found in salivary glands, lung, and skin. Its biological features have not been thoroughly characterized. Here we describe a primary AME originating from the tonsil. The pathologic changes were characterized by hypercellularity, the dominance of both epithelial and myoepithelial cells. Malignancy was evidenced by the presence of a high mitotic rate and invasive growth. The epithelial cells express high levels of cytokeratin and epithelial membrane antigen (EMA). The myoepithelial cells show positive staining for calponin, p63, vimentin, and S-100. A thorough review of the literature indicates that this is likely the first reported case of AME from the tonsil. Following descriptions of the diagnosis, treatment, and prognosis of this specific case, pathologic and clinical characteristics of AME from other tissues are also compiled and discussed.
Topics: Adenomyoepithelioma; Female; Humans; Middle Aged; Tonsillar Neoplasms
PubMed: 20356364
DOI: 10.1186/1758-3284-2-7 -
Medicine Oct 2020Breast adenomyoepithelioma (AME) is a rare tumor composed of myoepithelial cells and ductal or luminal cells. Most cases of AME are benign, but rare cases in which... (Review)
Review
Adenomyoepithelioma with a human epidermal growth factor receptor 2-fluorescence in situ hybridization-confirmed ductal carcinoma in situ component: A case report and review of the literature.
INTRODUCTION
Breast adenomyoepithelioma (AME) is a rare tumor composed of myoepithelial cells and ductal or luminal cells. Most cases of AME are benign, but rare cases in which either or both cell types exhibited malignant features have been reported. Due to its rarity, no diagnostic criteria for malignancy have been established for AME.
PATIENT CONCERNS
A 64-year-old woman presented with a mass in her right breast. Fine-needle aspiration cytology and biopsy examinations revealed lesions composed of spindle-shaped cells and round epithelial cells. AME was suspected, and partial mastectomy was performed.
DIAGNOSIS
The tumor specimen showed AME, which mainly consisted of spindle-shaped myoepithelial cells with slight atypia, admixed with tubular luminal cells and small areas of atypical intraductal proliferative lesions. No apparent features of malignancy, such as necrosis or invasion, were seen in the myoepithelial cells or the luminal or intraductal component. However, the atypical intraductal component exhibited focal nuclear atypia, a cribriform pattern, and moderate to strong membranous human epidermal growth factor receptor 2 (HER2) immunoreactivity. HER2 amplification was detected in focal regions of the atypical intraductal component by fluorescence in situ hybridization (FISH), which resulted in a diagnosis of AME with ductal carcinoma in situ.
OUTCOMES
The patient did not receive further therapy and was free from tumor recurrence at 23 months after the operation.
CONCLUSION
HER2 FISH might be useful for evaluating suspected AME tumors for malignancy when an atypical ductal lesion that lacks definitive features of malignancy is encountered.
Topics: Adenomyoepithelioma; Breast Neoplasms; Carcinoma, Intraductal, Noninfiltrating; Female; Humans; In Situ Hybridization, Fluorescence; Middle Aged; Receptor, ErbB-2
PubMed: 33080708
DOI: 10.1097/MD.0000000000022665 -
Modern Pathology : An Official Journal... Jun 2021Papillary neoplasms of the breast encompass a wide range of tumor types ranging from the benign intraductal papilloma to in situ and invasive papillary carcinomas. In... (Review)
Review
Papillary neoplasms of the breast encompass a wide range of tumor types ranging from the benign intraductal papilloma to in situ and invasive papillary carcinomas. In this review, we considered each tumor entity listed under the Papillary Neoplasms category in the latest WHO Classification of Breast Tumors (5th edition), namely intraductal papilloma, papillary ductal carcinoma in situ, encapsulated papillary carcinoma, solid-papillary carcinoma, and invasive papillary carcinoma. We examined their pathological features, current issues pertaining to diagnosis and prognostication, as well as the latest molecular findings. We also briefly addressed adenomyoepithelioma and the newly included tall cell carcinoma with reversed polarity, highlighting areas where they overlap with papillary neoplasms.
Topics: Breast Neoplasms; Carcinoma, Intraductal, Noninfiltrating; Carcinoma, Papillary; Female; Humans
PubMed: 33462367
DOI: 10.1038/s41379-020-00732-3 -
International Journal of Surgical... Jun 2020Adenomyoepithelioma is an extremely rare primary cutaneous neoplasm. Although there is ample evidence on the existence of malignant adenomyoepithelioma in the breast, a... (Review)
Review
Primary Cutaneous Adenomyoepithelioma Ex Spiradenoma With Malignant Histologic Features, Epithelial-Myoepithelial Carcinoma Type: A First Case Report With Molecular Studies.
Adenomyoepithelioma is an extremely rare primary cutaneous neoplasm. Although there is ample evidence on the existence of malignant adenomyoepithelioma in the breast, a malignant counterpart in the skin has not been documented. We report a primary cutaneous adenomyoepithelioma (pcAME) with malignant features arising from a spiradenoma in a 39-year-old female patient. The tumor was solid-cystic in appearance and entirely located in the subcutaneous tissue. Histologically, the tumor displayed foci of adenomatous changes and adenomyoepitheliomatous hyperplasia adjacent to a minute spiradenoma. Gradual increase of architectural complexity, cytologic atypia, mitotic activity, and infiltrative growth were observed in a significant portion of the neoplasm, indicative of transformation to adenomyoepithelioma and subsequently low- to high-grade salivary-type epithelial-myoepithelial carcinoma (EMCA). The intimate dual populations of ductal and myoepithelial cells were highlighted by a panel of immunohistochemical stains in all different components of the tumor. Molecular studies revealed a PIKCA3 mutation, a genetic aberration that has been documented in EMCA, particularly of breast origin. The current case documents for the first time a pcAME with malignant features arising from a spiradenoma and suggests adenomyoepithelioma ex spiradenoma as a possible tumorigenesis pathway of this rare cutaneous tumor.
Topics: Acrospiroma; Adenomyoepithelioma; Adult; Biomarkers, Tumor; Carcinoma; Female; Humans; Immunohistochemistry; Sweat Gland Neoplasms; Sweat Glands
PubMed: 31813296
DOI: 10.1177/1066896919888579 -
Revista Espanola de Patologia :... 2018Adenomyoepitheliomas of the breast are infrequent tumors with a variable histological appearance, and they can mimic several epithelial, myoepithelial and biphasic... (Review)
Review
Adenomyoepitheliomas of the breast are infrequent tumors with a variable histological appearance, and they can mimic several epithelial, myoepithelial and biphasic lesions of the breast. We have reviewed four cases of adenomyoepithelioma of the breast diagnosed between 2005 and 2015 in our institution (Hospital Clínico San Carlos). Mean age was 57years. All lesions were solid irregular masses located in the upper quadrants (3 of them in the right breast and one in the left), with an average size of 13mm. Microscopically 2 of them were tubular and the remaining 2 were lobulated subtypes. Hyaline, myxoid and cystic areas, peripheral pseudoinfiltration and satellite nodules were occasionally seen. Myoepithelial cells were fusiform and immunohistochemically they were actin, calponin, p63, S100 and CD10 positive and CKAE1-AE3 negative, with variable CK23BE12 and CK5/6 staining. In all cases lumpectomy was curative, no recurrences or malignant degeneration were observed.
Topics: Adenomyoepithelioma; Adult; Aged; Breast Neoplasms; Female; Humans; Middle Aged
PubMed: 29290325
DOI: 10.1016/j.patol.2016.12.001 -
International Journal of Surgery Case... 2020Adenomyoepithelioma is a rare tumor of the breast characterized by a dual/biphasic proliferation of two cell populations: the epithelial cells and the myoepithelial...
BACKGROUND
Adenomyoepithelioma is a rare tumor of the breast characterized by a dual/biphasic proliferation of two cell populations: the epithelial cells and the myoepithelial cells. The first case was reported in 1970. The majority of the cases are benign, but few malignant cases were reported in literature.
CASE PRESENTATION
A case of a 66-year-old lady presenting with an asymptomatic breast mass, of 18 × 17 × 15 mm size with irregular borders and negative metastatic workup. The patient was operated for wide local excision of the tumor, with a confirmed negative margins intraoperatively. The final pathology was Adenomyoepithelioma.
CONCLUSION
We report this rare case to encourage physicians to keep this etiology in mind as part of the differential diagnosis of breast mass.
PubMed: 33395868
DOI: 10.1016/j.ijscr.2020.11.110 -
The Breast Journal Nov 2017
Topics: Adenomyoepithelioma; Adult; Biopsy, Fine-Needle; Breast Neoplasms; Diagnosis, Differential; Female; Humans; Mammography; Neoplasms, Multiple Primary; Ultrasonography, Mammary
PubMed: 28397340
DOI: 10.1111/tbj.12820 -
Journal of the Korean Society of... Mar 2023This study aimed to evaluate the radiological and clinical characteristics of benign adenomyoepitheliomas of the breast.
PURPOSE
This study aimed to evaluate the radiological and clinical characteristics of benign adenomyoepitheliomas of the breast.
MATERIALS AND METHODS
Over the last 20 years, 120 patients were histologically diagnosed with breast adenomyoepithelioma (AME) at our institution. We excluded 43 patients who were incidentally diagnosed during mastectomy for breast cancer, 28 who underwent percutaneous biopsy without further excision, and 8 who had biopsy-confirmed benign AME and were found to have another pathology after complete excision. We retrospectively reviewed the clinical records and radiological findings of the remaining 41 patients with histologically diagnosed benign breast AMEs after complete excision.
RESULTS
All 41 patients underwent US; 38 underwent mammography (MG) and US; and 18 underwent MG, US, and MRI. MG detected 38 cases with a round or oval shape (56%), and mass (89%), were non-circumscribed (62%), hyperdense (53%), and without microcalcifications (95%). Breast US revealed suspicious masses (98%) with a non-circumscribed margin (66%), hypoechogenicity (43%), and intratumoral vascularity (63%). All lesions on breast MRI showed suspicious masses (100%) with ill-defined margins (61%), and 84% showed wash-out kinetics. Benign AMEs showed suspicious features of Breast Imaging Reporting and Data System (BI-RADS) category 4 or 5 in 83%-95% of the MG, US, and MRI. Sixteen of the 41 cases were misdiagnosed on the initial core needle biopsy and two were diagnosed as malignancy.
CONCLUSION
Benign breast AME often shows suspicious radiological features mimicking a malignant mass on MG, US, and MRI. Differentiating benign AME from other pathologies might be difficult on core needle biopsy, and complete excision is needed for a correct diagnosis.
PubMed: 37051396
DOI: 10.3348/jksr.2022.0021