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Journal of Breast Imaging Jan 2024Adenomyoepithelioma (AME) is a rare, usually benign breast neoplasm with low potential for malignant transformation. Imaging features are nonspecific and overlap with...
Adenomyoepithelioma (AME) is a rare, usually benign breast neoplasm with low potential for malignant transformation. Imaging features are nonspecific and overlap with other benign and malignant breast lesions. On mammography, AME most often presents as a mass, usually oval in shape, with variable reported margins. Less commonly, AME can present mammographically as an asymmetry or can be mammographically occult. Associated calcifications are uncommon. On US, AME is usually seen as a hypoechoic oval mass, but it can also manifest as a complex cystic and solid mass. On US, the majority of AME have noncircumscribed margins (indistinct, angular, or microlobulated). Internal vascularity is usually present, and posterior enhancement can be seen. Although there is limited literature on MRI features, the most frequent finding is an irregular mass with washout kinetics; T2 hyperintensity can be observed. These nonspecific and often suspicious imaging features usually merit biopsy. On histologic analysis, AME is characterized by a biphasic proliferation of myoepithelial and epithelial cells. Pathologic diagnosis can be difficult due to the variety of histologic features of AME and heterogeneity in these tumors, especially when sampling is limited, such as in core needle biopsies. Wide local surgical excision of AME is recommended due to potential for recurrence and malignant transformation.
Topics: Humans; Female; Adenomyoepithelioma; Breast; Breast Neoplasms; Mammography; Biopsy
PubMed: 38153758
DOI: 10.1093/jbi/wbad098 -
International Journal of Surgical... Aug 2022Adenomyoepithelioma comprises a spectrum of lesions with variable morphology and clinical behavior, presenting at a wide age range. The most common presenting symptom is...
Adenomyoepithelioma comprises a spectrum of lesions with variable morphology and clinical behavior, presenting at a wide age range. The most common presenting symptom is palpable abnormality. Mammographic abnormalities include focal asymmetries, masses and microcalcifications. Adenomyoepithelioma is a biphasic neoplasm characterized by proliferation of epithelial and myoepithelial cells. Adenomyoepitheliomas can be benign, atypical and malignant (adenomyoepithelioma with carcinoma). Malignant transformation occurs in either one or both cellular components leading to the development of invasive carcinoma. Invasive carcinoma types include invasive breast carcinoma of no special type, invasive lobular carcinoma, invasive carcinoma of special types, myoepithelial carcinoma, metaplastic carcinoma and biphasic carcinoma such as epithelial-myoepithelial carcinoma. While the majority of classic adenomyoepitheliomas have a benign clinical course and can be treated by local excision, local recurrence and distant metastasis have been reported. In malignant cases, treatment is determined by the associated carcinoma to include radiotherapy after breast conserving surgery and sentinel lymph node biopsy or axillary lymph node dissection, as indicated. Herein we report a case of a 62 year old woman who was found to have focal asymmetry on screening mammogram. She underwent a core biopsy of the lesion which showed atypical epithelial-myoepithelial neoplasm and excision was recommended. Upon excision, a diagnosis of malignant adenomyoepithelioma with associated epithelial-myoepithelial carcinoma was rendered with negative margins. The patient declined additional surgery for sentinel lymph node biopsy and declined adjuvant therapy. Six months after surgery, the patient is doing well with no complains. A follow-up mammogram and ultrasound of the axilla showed no abnormalities.
Topics: Adenomyoepithelioma; Breast; Breast Neoplasms; Carcinoma; Female; Humans; Mammography; Mastectomy, Segmental; Middle Aged; Myoepithelioma
PubMed: 35138180
DOI: 10.1177/10668969211070164 -
ANZ Journal of Surgery Dec 2023
Topics: Humans; Female; Adenomyoepithelioma; Breast; Neoplasms; Breast Neoplasms
PubMed: 37641233
DOI: 10.1111/ans.18676 -
American Journal of Clinical Pathology Dec 1992Adenomyoepithelioma of the breast is a rare tumor that, on the basis of histologic, immunohistochemical, and ultrastructural features, has a bicellular pattern of... (Review)
Review
Adenomyoepithelioma of the breast is a rare tumor that, on the basis of histologic, immunohistochemical, and ultrastructural features, has a bicellular pattern of epithelial and myoepithelial cells regularly distributed in tubular structures. Until now, this tumor was thought to be a benign or low-grade malignant lesion because of possible local recurrences (7 recurrent cases of 60 in the literature). Only one of these cases had nodal involvement, thereby suggesting the possible malignancy of this lesion. This paper reports the first documented case of malignant adenomyoepithelioma with lung metastases presenting the same biphasic pattern as the primary tumor.
Topics: Breast Neoplasms; Carcinoma, Adenoid Cystic; Female; Humans; Immunohistochemistry; Lung Neoplasms; Microscopy, Electron; Middle Aged
PubMed: 1334365
DOI: 10.1093/ajcp/98.6.598 -
Archives of Pathology & Laboratory... Apr 2000Malignant adenomyoepithelioma of the breast is a rare lesion characterized by malignant proliferation of epithelial and myoepithelial cells that show characteristic... (Review)
Review
Malignant adenomyoepithelioma of the breast is a rare lesion characterized by malignant proliferation of epithelial and myoepithelial cells that show characteristic histologic and immunohistochemical features. Eleven cases have been reported, 4 of which showed evidence of distant metastasis. The authors report a case of malignant adenomyoepithelioma in the axillary tail of a 71-year-old woman, one of the oldest patients described so far, and review the literature. Malignancy in the current case was evidenced by the presence of local invasion, high mitotic rate, and severe cytologic atypia. The tumor was associated with adenosis and lobular adenomyoepithelial hyperplasia. Malignant adenomyoepithelioma is a rare neoplasm, diagnosable by light microscopy and immunohistochemistry. To date, it has only been reported in women, who ranged in age from 26 to 76 years. Metastases have only been documented in tumors 2.0 cm in diameter or larger.
Topics: Aged; Breast Neoplasms; Carcinoma, Adenoid Cystic; Epithelial Cells; Female; Follow-Up Studies; Humans; Lymph Node Excision; Mammography; Mastectomy, Segmental; Neoplasm Invasiveness; Time Factors
PubMed: 10747327
DOI: 10.5858/2000-124-0632-MAOTBW -
Virchows Archiv : An International... Feb 2000We describe a patient who was admitted to our hospital with an enlarged left lobe of the thyroid gland. Since fine-needle aspiration showed atypical follicular cells, a... (Review)
Review
We describe a patient who was admitted to our hospital with an enlarged left lobe of the thyroid gland. Since fine-needle aspiration showed atypical follicular cells, a surgical exploration followed. Owing to extensive tumor infiltration into the surrounding tissues curative surgery was not possible, and only an incisional biopsy was taken. Histological examination of this biopsy revealed a mixed tumor composed of epithelial and myoepithelial cells. A primary thyroid tumor, metastasis of a salivary gland, and a skin appendage tumor could be excluded based on clinical examination, conventional histology, and immunohistochemistry. A tumor of the left breast treated 12 years earlier had originally been classified as an intraductal/intracystic carcinoma with focal invasion, but was re-examined. Using immunohistochemistry, the breast tumor was reclassified as a malignant adenomyoepithelioma. The current tumor was apparently a metastasis from this primary breast tumor. An updated review of the literature is given, including current knowledge on histological and immunohistochemical features of adenomyoepithelioma of the breast, with special attention to the reported pathological characteristics of recurrent and malignant tumors. Based on the reported pathological characteristics of recurrent and metastatic tumors we offer a diagnostic tool for identifying potentially malignant and recurrent tumors.
Topics: Biomarkers, Tumor; Biopsy, Needle; Breast Neoplasms; Carcinoma, Adenoid Cystic; Fatal Outcome; Female; Humans; Immunohistochemistry; Middle Aged; Thyroid Neoplasms
PubMed: 10755607
DOI: 10.1007/pl00008216 -
World Journal of Clinical Cases Oct 2021Adenomyoepithelioma (AME) of the breast is a rare type of benign breast tumor. Many AMEs show benign behavior, but reports of the malignant type are rare. We present the...
BACKGROUND
Adenomyoepithelioma (AME) of the breast is a rare type of benign breast tumor. Many AMEs show benign behavior, but reports of the malignant type are rare. We present the case of a patient with AME with repeated local recurrences and further malignant transformation.
CASE SUMMARY
A 53-year-old woman visited our hospital with a 16-mm palpable mass in the right breast. A core needle biopsy was performed. The pathological diagnosis was AME. Lumpectomy with a safety margin was performed without axillary lymph node dissection (ALND). Two years later, local recurrence developed, and the patient again underwent lumpectomy with a safety margin. The pathology showed malignant AME, and the margin was negative. Eight months later, local recurrence developed again in the same location, and a total mastectomy was performed without ALND. The pathological diagnosis was malignant AME. The patient was disease-free for three years posttreatment.
CONCLUSION
The treatment of AME requires caution, as it may exhibit repeated recurrences after local excision as well as malignant transformation.
PubMed: 34734068
DOI: 10.12998/wjcc.v9.i29.8864 -
La Radiologia Medica 2001
Review
Topics: Breast Neoplasms; Carcinoma; Female; Humans; Middle Aged; Radiography; Ultrasonography
PubMed: 11677443
DOI: No ID Found -
Surgery Today 2001Adenomyoepithelioma of the breast is a rare lesion, and has a bicellular pattern of epithelial and myoepithelial cells which are regularly distributed in the tubular... (Review)
Review
Adenomyoepithelioma of the breast is a rare lesion, and has a bicellular pattern of epithelial and myoepithelial cells which are regularly distributed in the tubular structures based on the histologic and ultrastructural features. It is thought to be a benign or a low-grade malignant disease. We herein describe a case of malignant adenomyoepithelioma of the breast with lung metastases in an 86-year-old woman. A primary massive tumor in the left breast grew rapidly within a short period of time. A simple mastectomy with sampling of the axillary lymph nodes was performed. The obtained lymph nodes did not include any metastatic lesions. Malignancy was evidenced by the presence of a high mitotic rate and severe nuclear atypia. Three months after the operation, radiology showed multiple lung metastases, and the patient died 2 weeks thereafter. Reviewing the literature, nine similar cases were reported, and the prognosis of malignant adenomyoepithelioma of the breast with distant metastases was very poor with the time of recurrence varying after initial treatments. Malignant adenomyoepithelioma should be followed up with careful screening for distant metastases.
Topics: Aged; Aged, 80 and over; Breast Neoplasms; Carcinoma, Adenoid Cystic; Female; Humans; Lung Neoplasms
PubMed: 11759886
DOI: 10.1007/s005950170031 -
Hematology/oncology and Stem Cell... 2009
Topics: Adenomyoepithelioma; Antineoplastic Agents; Breast Neoplasms; Female; Humans; Middle Aged; Tomography, X-Ray Computed; Treatment Outcome
PubMed: 20118063
DOI: 10.1016/s1658-3876(09)50028-3