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Cureus Mar 2017A 58-year-old female had a mass in the right breast palpable beneath the areola. A mammogram revealed a 1.5-centimeter soft tissue density that was confirmed with a...
A 58-year-old female had a mass in the right breast palpable beneath the areola. A mammogram revealed a 1.5-centimeter soft tissue density that was confirmed with a subsequent ultrasound. The patient underwent a core needle biopsy which was initially reported as a moderately differentiated invasive ductal carcinoma. Immunohistochemical analysis revealed negative staining for estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor (HER2), mammaglobin, and gross cystic disease fluid protein 15 (GCDFP-15). A wide local excision of the mass was performed. The pathology report stated the tumor had an infiltrative growth pattern with a desmoplastic stromal response with enhanced epithelial atypia consistent with malignant transformation of a nodular clear cell hidradenoma. Clear cell hidradenoma is a very rare tumor originating from the sweat gland and has a propensity for the face and extremities. The malignant variant of this tumor is extremely rare and has been reported to originate from the breast in few cases. This case represents the difficulty in diagnosing this tumor along with the radiographic and histologic features that can distinguish this malignancy from other entities.
PubMed: 28409065
DOI: 10.7759/cureus.1064 -
Diagnostic Pathology Mar 2017Histopathological diagnosis is important for prognostication and choice of treatment in patients with cancer in the lung. Metastases to the lungs are common and need to...
BACKGROUND
Histopathological diagnosis is important for prognostication and choice of treatment in patients with cancer in the lung. Metastases to the lungs are common and need to be distinguished from primary lung cancer. Furthermore, cases with synchronous or metachronous primary lung cancers (although infrequent) are often handled differently than cases with lung cancer with intrapulmonary metastasis or relapse, respectively. In some cases, morphology and immunohistochemical staining is not sufficient for certain diagnosis.
METHODS
The present study included six cases where molecular genetic analysis in form of pyrosequencing or targeted next-generation sequencing was of value for certain diagnosis of selected tumours in the lung.
RESULTS
Two of the included cases were rare metastases to the lung; colorectal cancer with IHC profile consistent with primary lung cancer and malignant adenomyoepithelioma of the breast, respectively, where molecular genetic analysis was of aid for proving the relationship to the primary tumour. The other four cases were multiple lung adenocarcinomas where molecular genetic analysis was of aid to distinguish between intrapulmonary metastasis and synchronous tumour.
CONCLUSIONS
Comparison of molecular genetic profile may be an important tool for determination of relationship between tumours in some situations and should always be considered in unclear cases. Further studies on concordance and discordance of molecular genetic profiles between spatially or temporally different tumours with common origin may be helpful for improved diagnostics of pulmonary tumours.
Topics: Adenocarcinoma; Adenocarcinoma of Lung; Adenomyoepithelioma; Aged; Biomarkers, Tumor; Biopsy; Breast Neoplasms; Colorectal Neoplasms; Diagnosis, Differential; Female; Gene Expression Profiling; Genetic Predisposition to Disease; High-Throughput Nucleotide Sequencing; Humans; Immunohistochemistry; Lung Neoplasms; Male; Middle Aged; Phenotype; Predictive Value of Tests; Sequence Analysis, DNA; Transcriptome
PubMed: 28347348
DOI: 10.1186/s13000-017-0621-8 -
Journal of Cardiothoracic Surgery Aug 2016Adenomyoepithelioma (AME) of the breast is a rare tumour of unpredictable clinical behaviour. Most of the tumours are benign with some giving local recurrences or... (Review)
Review
BACKGROUND
Adenomyoepithelioma (AME) of the breast is a rare tumour of unpredictable clinical behaviour. Most of the tumours are benign with some giving local recurrences or distant metastases.
CASE PRESENTATION
We report a case of late lung metastases in a woman with a history of breast adenomyoepithelioma. Partial lobectomy was performed for lung lesions and initial diagnosis was epithelial-myoepithelial carcinoma.
CONCLUSION
Careful slide's revision of both breast and pulmonary lesions showed identical microscopic appearance with lung tumour performing more malignant features. Tumour cells in both: breast and pulmonary lesions were positive for cytokeratin and EMA (epithelial cells) and also for SMA, S100 and vimentin (myoepithelial cells). Two years and 7 months follow-up showed no recurrent neoplastic disease in our patient.
Topics: Adenomyoepithelioma; Breast Neoplasms; Female; Humans; Lung Neoplasms; Middle Aged; Pneumonectomy
PubMed: 27487934
DOI: 10.1186/s13019-016-0518-8 -
Oncology Letters Jan 2016Breast osteosarcoma is a rare malignancy of unknown etiology, with no standard adjuvant treatment at present. The prognosis of the disease is poor, and it has a high...
Breast osteosarcoma is a rare malignancy of unknown etiology, with no standard adjuvant treatment at present. The prognosis of the disease is poor, and it has a high propensity for recurrence and metastasis. The current report presents the case of a 52-year-old woman, in whom adenomyoepithelioma gradually developed into breast osteosarcoma following three separate surgeries. The patient survived for 41 months from the initial lesion occurrence and resection in the left breast; during this time, she underwent surgery and chemotherapy (liposomal doxorubicin and cisplatin) for the treatment of disease recurrence and lung metastasis, along with molecular-targeted therapy (sunitinib). However, the patient eventually succumbed to respiratory failure due to progressive disease. The present case underwent a clear pathological transformation process, and may provide a basis for an improved understanding of the clinical characteristics and treatment of breast osteosarcoma.
PubMed: 26870284
DOI: 10.3892/ol.2015.3921 -
Indian Journal of Cancer 2015
Topics: Adenomyoepithelioma; Biopsy, Fine-Needle; Female; Humans; Lung; Middle Aged; Neoplasm Recurrence, Local; Submandibular Gland
PubMed: 26853410
DOI: 10.4103/0019-509X.175813 -
International Journal of Clinical and... 2015Lobulated adenomyoepithelioma of the breast is an extremely rare lesion, with hyperplasia of myoepithelial cells and glandular epithelial cells. We present a case of a...
Lobulated adenomyoepithelioma of the breast is an extremely rare lesion, with hyperplasia of myoepithelial cells and glandular epithelial cells. We present a case of a 51-year-old woman with a small painless hard lump in each breast. The lesion in the left breast was an irregular solid mass, and the right breast showed a subareolar nodule with bloodstained nipple discharge. The final diagnosis was intraductal papillary carcinoma in the right breast and lobulated adenomyoepithelioma in the left breast. In the left breast lesion, histopathologic examination revealed multiple nodules composed of proliferative glandular epithelial cells and surrounding myoepithelial cells. Solid nests of clear or eosinophilic myoepithelial cells proliferated around compressed epithelial-lined space. Smaller satellite nodules were seen. Immunohistochemistry revealed myoepithelial cells were positive for P63, smooth muscle actin, calponin, 34βE12, CK5/6 and CK14, while glandular epithelial cells were positive for AE1/AE3 and CK7. Lobulated adenomyoepithelioma has a high chance of recurrence and malignant degeneration due to inadequate excision. Therefore, understanding of the pathological morphology and accurate diagnosis is important for surgical planning. Moreover, close follow-up is recommended for patients with lobulated adenomyoepithelioma despite the lesion being reported as benign.
Topics: Adenomyoepithelioma; Biomarkers, Tumor; Biopsy; Breast Neoplasms; Carcinoma, Intraductal, Noninfiltrating; Carcinoma, Papillary; Diagnosis, Differential; Female; Humans; Immunohistochemistry; Middle Aged; Predictive Value of Tests; Tumor Burden; Unilateral Breast Neoplasms
PubMed: 26823903
DOI: No ID Found -
Journal of Breast Cancer Dec 2015Adenomyoepithelioma (AME) of the breast is an uncommon tumor characterized by its dual differentiation into luminal cells and myoepithelial cells. In most cases these...
Adenomyoepithelioma (AME) of the breast is an uncommon tumor characterized by its dual differentiation into luminal cells and myoepithelial cells. In most cases these tumors have a benign clinical course, but distant metastases have been reported. We present the case of a 51-year-old woman diagnosed with malignant AME. The patient underwent a right modified radical mastectomy, and pathological examination confirmed the diagnosis of malignant AME. Ten months after the operation, multiple hepatic, pleural, and abdominal wall metastases were detected. A number of palliative chemotherapeutic agents were tried, including anthracycline and taxanes. However, the disease continued to progress, and superior vena cava syndrome developed as a result of direct tumor invasion. The patient received salvage eribulin monotherapy. After two cycles of this treatment, her clinical symptoms were ameliorated, and a computed tomography scan showed a partial response. Eribulin chemotherapy was thus effective in treating malignant AME in this case.
PubMed: 26770248
DOI: 10.4048/jbc.2015.18.4.400 -
SpringerPlus 2015Differential diagnosis of spindle cell lesions of breast is challenging for certain reasons. The most important reason is the presence of cytological atypia and mitosis...
Differential diagnosis of spindle cell lesions of breast is challenging for certain reasons. The most important reason is the presence of cytological atypia and mitosis in all three conditions: reactive, benign, and malignant. Patients diagnosed with benign and malignant tumor/tumor-like lesions that had spindle cell components following the histopathological examination were included in the study. The patients' medical records were accessed to obtain the clinical history, follow-up notes, and radiological findings. Following histopathological, immunohistochemical, and clinical evaluations, the patients were diagnosed as follows: pseudoangiomatous stromal hyperplasia (PASH), bilateral desmoid-type fibromatosis (FM), adenomyoepithelioma (AME), myofibroblastoma (MFB), malignant phyllodes tumor (MF), high-grade AS, post-chemotherapy osteosarcoma (OS) + Paget's disease, and metaplastic carcinoma (MC). An algorithmic approach should be used in the diagnosis; cellular structure, presence and grade of atypia, growth pattern, mitotic activity, immunohistochemical staining, and clinical and radiological features should be evaluated together. Detection of some molecular changes can be useful in differential diagnosis.
PubMed: 26558181
DOI: 10.1186/s40064-015-1480-y -
Surgical Case Reports Dec 2015We herein report a case of adenomyoepithelioma (AME) of the breast with ductal carcinoma in situ (DCIS) involving a 71-year-old Japanese woman. She presented with bloody...
We herein report a case of adenomyoepithelioma (AME) of the breast with ductal carcinoma in situ (DCIS) involving a 71-year-old Japanese woman. She presented with bloody discharge from the left nipple. Mammography and ultrasonography showed a well-defined polygonal tumor. Fine-needle aspiration cytology of the mass and stamp cytology of the bloody nipple discharge showed malignancy. Mastectomy and a sentinel lymph node biopsy were performed. The final diagnosis was AME of the breast with DCIS. There are no reports of AME of the breast presenting with bloody nipple discharge; upon a diagnosis of AME of the breast with bloody nipple discharge, the possibility of the coexistence of breast cancer should thus be considered when encountering such cases.
PubMed: 26380805
DOI: 10.1186/s40792-015-0083-8 -
Pathobiology : Journal of... Sep 2015The identification of myoepithelial cells (MEC) is a valuable clue in the differential diagnosis of breast lesions. A series of breast lesions with occasional absence of...
OBJECTIVE
The identification of myoepithelial cells (MEC) is a valuable clue in the differential diagnosis of breast lesions. A series of breast lesions with occasional absence of or decrease in the staining for some MEC markers was analyzed for the expression of a novel marker, p40, and results were compared to the p63 staining profile.
METHODS
Samples (n = 34) from patients with benign sclerosing lesions (n = 11), ductal carcinoma in situ (n = 13) and adenomyoepithelial lesions (n = 10) and associated normal breast tissues (n = 31) were selected to evaluate the differential expression of p40 and p63 using immunohistochemistry. Triple-negative, cytokeratin 5 (CK5)-expressing invasive breast carcinomas (n = 19) were also assessed for p40 expression.
RESULTS
Normal structures showed similar diffuse and strong MEC positivity using p40 and p63 in all 31 cases. The two antibodies performed similarly in all 34 breast lesions acknowledged to present altered expression of MEC markers; focal losses of expression occurred in a parallel fashion. CK5-positive carcinomas expressed p40 more frequently than p63 (18/19 vs. 8/19) and the staining was more marked.
CONCLUSIONS
It seems that both antibodies can be used interchangeably for MEC identification, but show differences in the labeling at least in a subset of tumor cells in triple-negative carcinomas.
Topics: Adenomyoepithelioma; Adult; Aged; Biomarkers, Tumor; Breast; Breast Diseases; Breast Neoplasms; Carcinoma, Intraductal, Noninfiltrating; Diagnosis, Differential; Epithelial Cells; Female; Humans; Immunohistochemistry; Middle Aged; Transcription Factors; Triple Negative Breast Neoplasms; Tumor Suppressor Proteins
PubMed: 26330357
DOI: 10.1159/000375127