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Medical Ultrasonography Jun 2023
Topics: Humans; Female; Adenomyoepithelioma; Breast; Ultrasonography; Breast Neoplasms
PubMed: 37369056
DOI: 10.11152/mu-4034 -
Cureus May 2023An 81-year-old female patient underwent a screening mammogram one year after completing treatment for right-sided estrogen receptor (ER)/progesterone receptor...
An 81-year-old female patient underwent a screening mammogram one year after completing treatment for right-sided estrogen receptor (ER)/progesterone receptor (PR)-negative ductal carcinoma in situ (DCIS). A new 1-cm mass was noted in the contralateral breast. Ultrasound and percutaneous core needle biopsy results were suggestive of an atypical papillary lesion. An excisional biopsy was performed, and the final pathology was consistent with a benign adenomyoepithelioma (AME). Surgical resection was considered her definitive treatment. AME of the breast is a rare clinical entity, with only a handful of case reports and case series available. In this case report, we review common clinical and radiologic presentations, methods of diagnosis, and recommendations for management based on current literature. The presence of an AME in the background of a previous or synchronous breast malignancy occurs in a very small percentage of cases. On review of available literature, we identified other cases with a past or current history of breast malignancy.
PubMed: 37332453
DOI: 10.7759/cureus.39189 -
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 -
Indian Journal of Surgical Oncology Mar 2023Breast adenomyoepithelioma is an unusual tumour characterized by a biphasic proliferation of epithelial and myoepithelial cells. Most of the breast adenomyoepitheliomas...
Breast adenomyoepithelioma is an unusual tumour characterized by a biphasic proliferation of epithelial and myoepithelial cells. Most of the breast adenomyoepitheliomas are considered to be benign and characterized by propensity for local recurrence. Malignant change can occur rarely in one or both cellular components. We here present a case of a 70-year-old previously healthy female who initially presented with a painless breast lump. The patient underwent wide local excision in view of suspicion of malignancy and sent for frozen section regarding the diagnosis and margins which surprisingly came as adenomyoepithelioma. Final histopathology came as low-grade malignant adenomyoepithelioma. The patient shows no sign of tumour recurrence in the follow up.
PubMed: 36891425
DOI: 10.1007/s13193-022-01583-x -
American Journal of Translational... 2022Malignant adenomyoepithelioma (MAME) of the breast is an extremely rare breast malignancy, in which they arise from either luminal epithelial or myoepithelial...
BACKGROUND
Malignant adenomyoepithelioma (MAME) of the breast is an extremely rare breast malignancy, in which they arise from either luminal epithelial or myoepithelial components, or both. At present, there is very little clinical data of MAME.
CASE REPORT
We present two cases, one of them is a 34-year-old woman who underwent needle biopsy for a 3.2 cm-size mass in the right breast, and the pathology was MAME of breast. Another case is a 45-year-old woman who had a 3.0 cm-size mass in the right breast. We performed a breast-conserving surgery and sentinel lymph node biopsy, both of which were negative. The histopathology of these two cases was invasive carcinoma; however, these cases were eligible for MAME of the breast through combining with immunohistochemistry.
CONCLUSIONS
MAME of the breast is very rare, and has a diverse cell morphology, which must be combined with immunohistochemistry to make a clear diagnosis. Besides, it should be differentiated from adenoid cystic cancer, malignant leafy tumor, spindle cell carcinoma, etc. The clinical characteristics and treatment strategies were further discussed in combination with the literature.
PubMed: 36628238
DOI: No ID Found -
Frontiers in Surgery 2022Breast malignant adenomyoepithelioma (MAME) after breast augmentation has never been reported.
BACKGROUND
Breast malignant adenomyoepithelioma (MAME) after breast augmentation has never been reported.
CASE SUMMARY
We reported a case of a 55-year-old woman who was diagnosed with breast MAME 16 years after breast augmentation. Breast augmentation was performed on the patient with two 200 ml round textured prostheses in the subpectoral plane through axillary incisions in 2004. However, a breast ultrasound in 2020 revealed a suspicious malignant lump in the right breast, which was finally confirmed as MAME by pathology. Skin-sparing modified radical mastectomy and immediate breast reconstruction with expander implantation were performed. Subsequently, the patient received three cycles of chemotherapy with the regimen of anthracycline and cyclophosphamide. In the following nearly 2 years of follow-up, no tumor recurrence and metastasis were found, and the overall treatment was satisfactory for the patient.
CONCLUSION
Here, we present a unique case in which a patient was diagnosed with breast MAME after breast augmentation. Skin-sparing modified radical mastectomy and immediate breast reconstruction with expander implantation are feasible approaches that yield at least short-term oncological safety and acceptable aesthetic results. However, whether there is a potential relationship between MAME and breast implants remains to be further explored. Meanwhile, due to the rarity of breast MAME, more authoritative strategies considering both oncological safety and aesthetics to seek better long-term therapeutic effects are needed.
PubMed: 36311924
DOI: 10.3389/fsurg.2022.981045 -
Archives of Pathology & Laboratory... Jan 2023Spindle cell lesions of the breast represent a broad spectrum of entities, ranging from nonneoplastic reactive conditions to high-grade malignant tumors. The wide range...
CONTEXT.—
Spindle cell lesions of the breast represent a broad spectrum of entities, ranging from nonneoplastic reactive conditions to high-grade malignant tumors. The wide range makes breast spindle cell lesions a diagnostic pitfall.
OBJECTIVE.—
To review the classification of spindle cell lesions of the breast, including clinical features, morphologic characteristics, and the role of immunohistochemistry as well as molecular tools in assisting the differential diagnosis. A diagnostic algorithm will be proposed.
DATA SOURCES.—
Literature and personal experience are the sources for this study.
CONCLUSIONS.—
Spindle cell lesions of the breast can be classified as biphasic or monophasic, with the former including both spindle cell and epithelial components, and the latter including only spindle cell elements. Each category is further subclassified as low or high grade. In the biphasic low-grade group, fibroadenoma and benign phyllodes tumor are the most common lesions. Other uncommon lesions include hamartoma, adenomyoepithelioma, and pseudoangiomatous stromal hyperplasia. In the biphasic high-grade group, borderline/malignant phyllodes tumor and biphasic metaplastic carcinoma are the main lesions to consider. In the monophasic low-grade group, reactive spindle cell nodule, nodular fasciitis, myofibroblastoma, fibromatosis, and fibromatosis-like metaplastic carcinoma have to be considered. In the monophasic high-grade group, the possible lesions are monophasic spindle cell metaplastic carcinoma, primary breast sarcoma, and metastases. Awareness of the clinical history and careful evaluation of any epithelial differentiation (with a large immunohistochemical panel) are crucial in the distinction.
Topics: Humans; Female; Phyllodes Tumor; Breast; Breast Neoplasms; Carcinoma; Fibroma; Algorithms; Diagnosis, Differential
PubMed: 35976671
DOI: 10.5858/arpa.2022-0048-RA -
Journal of Medical Case Reports Aug 2022Adenomyoepithelioma of the breast is an uncommon subtype of breast neoplasm that occurs in adults over a wide age range but most commonly in middle-aged and older...
BACKGROUND
Adenomyoepithelioma of the breast is an uncommon subtype of breast neoplasm that occurs in adults over a wide age range but most commonly in middle-aged and older adults. It usually presents as a solitary palpable mass or is detected on breast radiographic images. Histologically, it is a biphasic tumor with proliferation of both the epithelial and myoepithelial components of the glands, with variable types of tissue metaplasia.
CASE PRESENTATION
A 64-year-old Saudi woman who underwent regular breast screening (mammogram) presented to our hospital following radiographic detection of a suspicious grouped microcalcification in the upper outer quadrant of her right breast on the mammogram. A wide local excision of the right breast lump was performed. Following histopathological examination of the breast lump, the final diagnosis was breast adenomyoepithelioma with mucoepidermoid/divergent differentiation, with no evidence of malignancy. About two years after the operation, a clinical follow-up conducted outside our hospital showed the development of ductal carcinoma in situ in the same breast.
CONCLUSION
Although the prognosis and the plan of treatment remains the same, our case highlights the complexities in making an accurate diagnosis between the various types of metaplasia within adenomyoepithelioma on one hand and the presence of mucoepidermoid differentiation in adenomyoepithelioma on the other.
Topics: Adenomyoepithelioma; Aged; Breast; Breast Neoplasms; Female; Humans; Metaplasia; Middle Aged; Myoepithelioma
PubMed: 35934703
DOI: 10.1186/s13256-022-03507-3 -
Oxford Medical Case Reports Jun 2022Carney complex (CNC) is a rare multiple tumour syndrome characterized by cutaneous pigmented lesions, myxoma and endocrine tumours, among others, and is inherited as an...
Carney complex (CNC) is a rare multiple tumour syndrome characterized by cutaneous pigmented lesions, myxoma and endocrine tumours, among others, and is inherited as an autosomal dominant trait. Protein kinase cAMP-dependent type I regulatory subunit alpha () is known to be the responsible gene. Breast myxomatosis and ductal adenoma, which are regarded as benign, are well-known mammary lesions of CNC and are included in the main diagnostic criteria. In this case, a 59-year-old woman with repeated cardiac myxoma was diagnosed with CNC with mutation. She also had three multiple breast tumours bilaterally: breast cancer, adenomyoepithelioma and intraductal papilloma. In mammary lesions of CNC, attention should be paid to benign lesions, such as breast myxomatosis or ductal adenomas, and the development of breast cancer or breast tumours with malignant potential. Mammary lesions should be aggressively scrutinized and considered for resection, as required.
PubMed: 35769184
DOI: 10.1093/omcr/omac063 -
World Journal of Clinical Cases May 2022Pleomorphic adenoma (PA) is the most common type of salivary gland tumor, and its common sites are parotid gland, sinus, nasal septum and cleft palate. PA is an uncommon...
BACKGROUND
Pleomorphic adenoma (PA) is the most common type of salivary gland tumor, and its common sites are parotid gland, sinus, nasal septum and cleft palate. PA is an uncommon benign type of tumor occurring in the breast, and there are few reports of cases in Asia.
CASE SUMMARY
An 84-year-old woman found a mass in the upper outer quadrant of the right breast > 1 year ago. The patient underwent a right breast lumpectomy and sentinel lymph node biopsy. The pathological diagnosis was PA in the upper outer quadrant of the right breast, and the malignant component was malignant adenomyoepithelioma. The postoperative course was uneventful, and no chemotherapy was administered. At 18 mo of follow-up, the patient is alive and well, with no evidence of recurrent disease.
CONCLUSION
Patients with breast PA should first undergo extended excision of breast masses followed by pathological examination. If malignancy is confirmed or the surgical margin is positive, modified radical mastectomy should be performed.
PubMed: 35663065
DOI: 10.12998/wjcc.v10.i14.4648