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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 -
WT1 as a myoepithelial marker: a comparative study of breast, cutaneous, and salivary gland lesions.Human Pathology May 2023WT1 immunostain is expressed in various benign and malignant neoplasms, as well as normal myoepithelial cells. WT1 shows differential expression in non-neoplastic,...
WT1 immunostain is expressed in various benign and malignant neoplasms, as well as normal myoepithelial cells. WT1 shows differential expression in non-neoplastic, benign, and malignant neoplastic myoepithelial cells of the salivary gland. In this study, WT1 immunostain and other myoepithelial markers were compared to investigate the value of WT1 as a myoepithelial marker, and to delineate the expression profile of WT1 in nonsalivary gland myoepithelial cells. WT1, p63, and calponin immunostains were performed on normal and lesional tissues from the breast (adenosis, sclerosing adenosis, lactating adenoma, nipple adenoma, tubular adenoma, adenomyoepithelioma, and adenoid cystic carcinoma [ACC]), skin (cutaneous mixed tumor, hidradenoma, spiradenoma, and ACC), and salivary gland (pleomorphic adenoma and ACC). The stained slides were digitized and orientated with H&E images and assessed simultaneously using QuPath. A total of 129, 58, and 56 breast, cutaneous, and salivary gland lesions, respectively, were included. There was poor agreement between WT1-p63 and WT1-calponin (κ < 0.1) in all organs, with absence of WT1 expression in normal salivary gland myoepithelium and most ACCs. There were no significant differences in WT1 expression in myoepithelial cells in normal breast tissue and benign breast neoplasms. Compared to pleomorphic adenomas, cutaneous mixed tumors showed lower WT1 expression (P < .001). WT1 is a less sensitive myoepithelial marker than calponin and p63. However, its unique pattern of expression in salivary gland primary for pleomorphic adenomas/cutaneous mixed tumor can favor a diagnosis of benign salivary gland tumors, particularly in small biopsy specimens.
Topics: Female; Humans; Adenoma, Pleomorphic; Lactation; Biomarkers, Tumor; Salivary Glands; Salivary Gland Neoplasms; Carcinoma, Adenoid Cystic; Adenoma; WT1 Proteins
PubMed: 36739952
DOI: 10.1016/j.humpath.2023.01.005 -
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 -
Journal of Clinical Ultrasound : JCU Jun 2023
Topics: Humans; Female; Carcinoma, Intraductal, Noninfiltrating; Adenomyoepithelioma; Breast; Breast Neoplasms; Carcinoma, Ductal, Breast
PubMed: 36189898
DOI: 10.1002/jcu.23357 -
Zhonghua Bing Li Xue Za Zhi = Chinese... Sep 2022
Topics: Adenomyoepithelioma; Breast; Humans; Neoplasms
PubMed: 36097909
DOI: 10.3760/cma.j.cn112151-20220415-00290 -
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 -
Breast Disease 2022Breast adenomyoepithelioma is a very uncommon tumor, which is generally considered to be benign, however malignant transformation has been reported.
INTRODUCTION
Breast adenomyoepithelioma is a very uncommon tumor, which is generally considered to be benign, however malignant transformation has been reported.
PRESENTATION OF CASE
We report two cases of two women with breast adenomyoepithelioma.
CONCLUSION
Diagnosis of adenomyoepithelioma is challenging because tumor may mimic other breast diseases. It has neither specific clinical signs nor radiological features, and the diagnosis is based on histopathological examination of the lesion. The treatment of choice is surgery. The type of surgery depends on the tumor factors and breast size. In malignant cases treatment such as radiotherapy, chemotherapy, immunotherapy may be used as well. It is very important to give an adequate treatment, otherwise the risk of tumor recurrence, growth or even metastatic spread, when tumor has malignant potential, increases.
Topics: Adenomyoepithelioma; Breast Neoplasms; Cell Transformation, Neoplastic; Female; Humans; Neoplasm Recurrence, Local
PubMed: 35811510
DOI: 10.3233/BD-210077 -
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