ABSTRACT
The malignant adenomyoepithelioma is a rare mammary tumor in women and uncommon in cats with only one report in this species. In this case report, the histopathological and immunohistochemical characteristics of six cases of malignant adenomyopithelioma in the feline mammary gland are described. Microscopic evaluation of tumors showed dense cellular neoplastic proliferation, composed of malignant myoepithelial and epithelial cells, formed by varied arrangements and presenting papillary, tubular and solid nest proliferation. Immunohistochemistry was performed for markers Ki67, Cox-2, RE, RP, p63 and HER-2. All cases were positive for p63, confirming the myoepithelial nature of neoplastic cells. The diagnosis of malignant adenomyopithelioma was made possible through the association between histopathological characteristics and immunohistochemical results.(AU)
O adenomioepitelioma maligno é uma neoplasia mamária rara em mulheres e incomum em gatas, possuindo apenas uma descrição nessa espécie. Neste relato de caso, são descritas as características histopatológicas e imuno-histoquímicas de seis casos de adenomioepitelioma maligno na glândula mamária felina. A avaliação microscópica dos tumores demonstrou proliferação neoplásica densamente celular, composta por células mioepiteliais e epiteliais malignas dispostas em padrão papilar, tubular e ninhos sólidos. Foi realizada técnica de imuno-histoquímica para os marcadores Ki67, Cox-2, RE, RP, p63 e HER-2. Todos os casos foram positivos para p63, confirmando a natureza mioepitelial das células neoplásicas. O diagnóstico de adenomioepitelioma maligno foi possível por meio da associação entre as características histopatológicas e os resultados de imuno-histoquímica.(AU)
Subject(s)
Animals , Female , Cats , Adenomyoepithelioma/diagnosis , Adenomyoepithelioma/veterinary , Immunohistochemistry/veterinary , Mammary Neoplasms, Animal/diagnosisABSTRACT
Breast adenomyoepitheliomas are composed of a biphasic proliferation of myoepithelial cells around small epithelial-lined spaces. Due to the rarity of adenomyoepitheliomas, the molecular data describing them are limited. Adenomyoepitheliomas are considered to be benign or have low malignant potential, and be prone to local recurrence. Malignant transformation has been associated with homozygous deletion of CDKN2A or somatic mutations in TERT, but remains unexplained in many cases. Here, we describe a case of carcinomatous transformation of both epithelial and myoepithelial cells in an estrogen receptor-negative adenomyoepithelioma caused by amplification of MYC. Break-apart fluorescence in situ hybridization revealed an increase in the MYC gene copy number (3–4 copies/cell in 37%, > 4 copies/cell in 40%). Deregulation of MYC is responsible for uncontrolled proliferation and cellular immortalization in basal-like breast cancers. Our case demonstrates that genomic instability events associated with gene amplification may be involved in the carcinogenesis of malignant adenomyoepitheliomas.
Subject(s)
Adenomyoepithelioma , Breast Neoplasms , Breast , Carcinogenesis , Estrogens , Fluorescence , Gene Amplification , Genes, myc , Genomic Instability , In Situ Hybridization , In Situ Hybridization, Fluorescence , RecurrenceABSTRACT
Adenomyoepithelioma (AME) is a rare breast lesion with balanced proliferation of both epithelial and myoepithelial cells. Patients usually present with a solitary mass without pain and nipple discharge. Although the tumor is generally considered benign, it has potential for local recurrence, metastasis, or malignant change. Approximately 150 cases have been reported in the medical literature, of which 40 cases were malignant or potentially malignant. But among them, elastographic findings have been reported in only two cases and still remain unclear. Herein, we now present a case of breast AME with emphasis on elastography.
Subject(s)
Humans , Adenomyoepithelioma , Breast Neoplasms , Breast , Elasticity Imaging Techniques , Neoplasm Metastasis , Nipples , Recurrence , UltrasonographyABSTRACT
We present what is believed to be the first report of heterogeneous carcinoma arising from breast ductal adenoma. A 57-year-old woman presented with a nodule in her right breast. Histological examination of a vacuum-assisted biopsy specimen revealed epithelial tubular proliferation and papillary apocrine epithelium. The myoepithelial cells lining the tubules were confirmed by immunohistochemistry. The nodule had increased in size 18 months later and tumorectomy was performed. The surgical specimen revealed proliferating apocrine epithelium with sheet-like and cribriform architecture within a mammary duct. Some myoepithelial cells showed irregular proliferation around the tubular epithelium. All three components, including apocrine, myoepithelial and glandular cells, showed prominent nuclear atypia and significant mitotic activity. The patient was diagnosed with malignant transformation of ductal adenoma. The malignant potential of ductal adenoma has not previously been discussed, but this heterogeneous carcinoma could represent a serious pitfall in the diagnosis of ductal adenomas.
ABSTRACT
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.
Subject(s)
Female , Humans , Middle Aged , Abdominal Wall , Adenomyoepithelioma , Breast , Diagnosis , Drug Therapy , Mastectomy, Modified Radical , Neoplasm Metastasis , Phenobarbital , Superior Vena Cava Syndrome , TaxoidsABSTRACT
Adenomyoepithelioma is a rarely occurring tumor and its generation in the limbs is extremely rare. We report a case of an adenomyoepithelioma over the proximal tibial tuberosity that was treated without any complications after an excisional biopsy with a literature review.
Subject(s)
Adenomyoepithelioma , Biopsy , Extremities , KneeABSTRACT
Metaplastic carcinoma of the breast is rare. We report a case in a 53-year-old woman who presented with a rapidly-growing breast mass. The lesion had a complex echogenicity in ultrasonography and a high signal intensity in a T2-weighted image with rim enhancement in contrast-enhanced MR images. The PET/CT images showed high uptake for the lesion. The lesion was biopsied and found to be a metaplastic carcinoma with an adenomyoepithelioma component. Although metaplstic carcinoma was difficult to differentiate from other common breast cancers, it showed complex echogenicity on ultrasonography and high signal intensity on a T2 weighted image with rim enhancement on contrast-enhanced MR images.
Subject(s)
Female , Humans , Middle Aged , Adenomyoepithelioma , BreastABSTRACT
Adenomyoepitheliomas (AMEs) are rare breast lesions, which are characterized by the proliferation of epithelial and myoepithelial cells. They are circumscribed lesions, which can be clinically and mammographically detected. However, when they are indistinctly limited, differential diagnosis with malignant lesions becomes difficult. In this paper, we report a case of adenomyoepithelioma with malignant transformation of the myoepithelial component, a rare histological type that arises from the malignant transformation of epithelial, myoepithelial, or both elements. Its course and prognosis are uncertain. Mastectomy with sentinel lymph node biopsy followed by radiotherapy are the most effective treatment approaches.
Adenomioepiteliomas (AMEs) são lesões raras na mama, caracterizadas pela proliferação de elementos epiteliais e mioepiteliais. Clínica e mamograficamente apresentam-se como lesões bem delimitadas, que, quando assumem aspecto mal delimitado, tornam difícil o diagnóstico diferencial com lesões malignas. Relatamos um caso de AME com transformação maligna do componente mioepitelial, tipo histológico ainda mais raro, que surge da transformação maligna de elementos epiteliais, mioepiteliais ou ambos. Seu curso e seu prognóstico são incertos, contudo, mastectomia com pesquisa de linfonodo sentinela seguidos de radioterapia constituem a forma mais efetiva de tratamento.
Subject(s)
Humans , Female , Adenomyoepithelioma/complications , Adenomyoepithelioma/diagnosis , Adenomyoepithelioma/therapy , Carcinoma/complications , Diagnosis, Differential , ImmunohistochemistryABSTRACT
El adenomioepitelioma es un infrecuente tumor de la mama, conformado por una proliferación bifásica de células epiteliales y mioepiteliales. Presentamos las características clínicas y morfológicas de un caso de adenomioepitelioma benigno diagnosticado en una paciente de 34 años en la Unidad de Anatomía Patológica del Hospital Hernán Henríquez Aravena de Temuco.
Breast adenomyoepithelioma is a rare tumor, characterized bythe biphasic proliferation of epithelial and myoepithelial cells. We present clinical and morphological features of a case of benign adenomyoepithelioma diagnosed in a 34 year old patient in the Hernán Henríquez Aravena Hospital in Temuco.
Subject(s)
Female , Adenomyoepithelioma/surgery , Adenomyoepithelioma/diagnosis , Adenomyoepithelioma/pathology , Adenomyoepithelioma/ultrastructure , Breast Neoplasms/surgery , Breast Neoplasms/diagnosis , Breast Neoplasms/pathology , Breast Neoplasms/ultrastructure , Diagnosis, Differential , Myoepithelioma/classification , Myoepithelioma/diagnosis , Myoepithelioma/pathology , Myoepithelioma/ultrastructureABSTRACT
Adenomyoepithelioma (AME) is a rare benign tumor composed of myoepithelial cells (MECs) which are located beneath the epithelial cells of exocrine glands, especially in breast and salivary glands. These tumor cells show biphasic proliferation of epithelial and MECs. Malignant AME is characterized by distant metastasis, local recurrence, cytologic atypia, high mitotic activity and infiltrating tumor margins. A 51-year-old woman presented with an 8 months growth in the left breast. She underwent core-needle biopsy and consecutively mammotome assisted biopsy at a local clinic. After resection, she complained about re-growing remnant lesion and a newly developed solid mass in the right breast. Finally, the remnant mass in the left breast was diagnosed with myoepithelial carcinoma. Concurrently, contralateral breast mass was diagnosed with invasive micropapillary carcinoma. Herein we report an unusual case of synchronous myoepithelial carcinoma and invasive micropapillary carcinoma of the breast with a review of literatures.
Subject(s)
Female , Humans , Middle Aged , Adenomyoepithelioma , Amphotericin B , Biopsy , Breast , Epithelial Cells , Exocrine Glands , Neoplasm Metastasis , Recurrence , Salivary GlandsABSTRACT
Adenomyoepithelioma of the breast is a rare tumor. Malignant change arising in this lesion is infrequent and only a few cases have been reported. We discuss a case of a 56-year-old female presenting with a firm breast mass, which was interpreted as myoepithelial carcinoma arising in a background of adenomyoepithelioma, based on morphological and immunohistochemical studies. This case is being highlighted for its rarity and distinct morphological spectrum.
ABSTRACT
O adenomioepitelioma é uma neoplasia caracterizada por uma proliferação de células epiteliais e mioepiteliais. Essa lesão pode ser encontrada em glândulas salivares, anexos de pele e, muito raramente, na glândula mamária. O adenomioepitelioma foi descrito pela primeira vez em 1970 e muito poucos casos foram publicados desde então. Nós apresentamos o caso de uma mulher de 32 anos com um tumor de 5 cm localizado no quadrante inferior externo que se estendia para o quadrante central e inferior interno da mama esquerda. A paciente apresentava ainda uma lesão satélite de 2 cm no quadrante superior interno da referida mama. Um linfonodo suspeito foi palpado na axila ipsilateral. A paciente foi classificada como no estádio IIIb do sistema TNM. A mamografia mostrou uma lesão infiltrativa categorizada como BI-RADS 4C. Foi realizada uma core-biopsy e uma biópsia incisional. Os exames histopatológico e imunoistoquímico mostraram tratar-se de um carcinoma adenomioepitelial. A paciente foi, então, submetida à mastectomia radical modificada, e o exame histopatológico confirmou o diagnóstico de carcinoma adenomioepitelial; 38 linfonodos axilares dissecados se apresentavam livres de metástases. Foram realizadas radioterapia e quimioterapia como tratamentos complementares. Como a paciente apresentava receptores hormonais negativos, nenhuma forma de tratamento hormonal complementar foi realizada. A paciente se encontrava viva e sem evidência de doença após 27 meses do diagnóstico.
The adenomioepitelioma is a neoplasm characterized by a proliferation of epithelial and myoepithelial cells. This injury can be found in the salivary glands, skin attachments and very rarely in the mammary gland. The adenomioepitelioma was first described in 1970 and very few cases have been published since then. We present the case of a woman of 32 years with a 5 cm tumor located in the lower outer quadrant extending into the central and lower inner quadrant of left breast. The patient still had a satellite lesion 2 cm in the upper inner quadrant of that breast. One suspect was palpable lymph nodes in the ipsilateral axilla. The patient was classified as stage IIIb in the TNM system. Mammography showed an infiltrative lesion classified as BI-RADS 4C. We performed a biopsy and a core-biopsy. Histopathologic and immunohistochemistry showed that it was a adenomioepitelial carcinoma. The patient then underwent modified radical mastectomy, and histopathology confirmed the diagnosis of carcinoma adenomioepitelial, 38 axillary lymph nodes dissected was presented free of metastases. Radiotherapy and chemotherapy were performed as complementary treatments. As the patient had hormone receptor-negative, no further form of hormonal treatment was performed. The patient was alive and without evidence of disease after 27 months of diagnosis.
Subject(s)
Humans , Female , Adult , Myoepithelioma/pathology , Breast Neoplasms/diagnosis , Breast Neoplasms/pathology , Immunohistochemistry , Biopsy, Needle , Mastectomy, RadicalABSTRACT
OBJECTIVE: The purpose of this study was to evaluate the ultrasonographic features of benign adenomyoepithelioma of the breast. MATERIALS AND METHODS: Between 2005 and 2009, five patients had histologically confirmed adenomyoepithelioma of the breast. We retrospectively evaluated the ultrasonographic findings of the tumors in correlation with the pathology, and reviewed medical records. RESULTS: The clinical manifestations included a palpable mass in three patients, while mammographic screening helped detect abnormalities in two patients. Ultrasonograms showed masses with an oval (n = 3) or irregular (n = 2) shape, with uncircumscribed (n = 4) or relatively well-circumscribed (n = 1) margins, as well as with a hypoechoic (n = 3) or a complex echoic (n = 2) internal echo texture. Three patients had focal ductectasia adjacent to the mass. The ultrasonographic assessments were classified as Breast Imaging Reporting and Data System (BI-RADS) category 4A, with low suspicion of malignancy in two cases, and as category 4B, with intermediate suspicion of malignancy in three cases. The pathology revealed benign adenomyoepithelioma in all patients. CONCLUSION: Benign adenomyoepitheliomas appear as solid or complex echoic masses with suspicious malignant ultrasonographic features, which may be associated with adjacent ductectasia. Although adenomyoepithelioma is a rare breast tumor, awareness of its sonographic features will be helpful for the differential diagnosis from other tumors.
Subject(s)
Adult , Aged , Female , Humans , Middle Aged , Adenomyoepithelioma/pathology , Breast Neoplasms/pathology , Magnetic Resonance Imaging , Mammography , Neoplasm Staging , Positron-Emission Tomography , Retrospective Studies , Tomography, X-Ray Computed , Ultrasonography, MammaryABSTRACT
An adenomyoepithelioma (AME) is an uncommon neoplasm characterized by proliferation of both epithelial and myoepithelial cells in the salivary gland, skin, lung and breast. AMEs can recur, progress to malignancy and metastasize. A 68-year-old woman presented a large mass occupying her whole right breast. The mass had grown slowly for about 20 years and the preoperative biopsy of the mass was chondroid syringoma. The mass was completely resected and the postoperative biopsy revealed malignant AME with a negative resection margin. The patient didn't receive any adjuvant therapy and has been free of recurrence or metastasis up to now. We report herein a case of a malignant AME that was diagnosed in the largest breast mass reported to date. This mass grew slowly and without metastasis. Clinicians should consider this rare disease entity in the differential diagnosis of a breast mass and remember the importance of complete excision of this tumor.
Subject(s)
Aged , Female , Humans , Adenoma, Pleomorphic , Adenomyoepithelioma , Amphotericin B , Biopsy , Breast , Diagnosis, Differential , Lung , Neoplasm Metastasis , Rare Diseases , Recurrence , Salivary Glands , SkinABSTRACT
An adenomyoepithelioma of the breast is an uncommon tumor that is characterized by biphasic lesions, which consist of epithelial and myoepithelial cells. Most adenomyoepitheliomas are benign, and a malignant transformation is rare. It is generally limited to the epithelial component but in rare cases, the myoepithelial component may become malignant and give rise to a malignant myoepithelioma. We encountered a case of a 29-year-old woman who presented with both an epithelial and myoepithelial carcinoma of the breast in an adenomyoepithelioma. The malignancy was evidenced by the presence of pleomorphism, a high mitotic rate and local invasion. Immunohistochemical staining demonstrated the expression of cytokeratin in epithelial cells and actin in myoepithelial cells. We report this case of a malignant adenomyoepithelioma of the breast with review of the relevant literature.
Subject(s)
Adult , Female , Humans , Actins , Adenomyoepithelioma , Breast , Epithelial Cells , Keratins , MyoepitheliomaABSTRACT
Adenomyoepithelioma occurs often in the salivary gland. But adenomyoepithelioma of the breast is very rare, and diagnostic tools are not found. The biological characters of disease are not fully understood. These days, a few case was reported in Korea with development of pathologic diagnostic tools. At first, we diagnosed this case as breast cancer and did MRM operation. But this case was diagnosed as adenomyoepithelioma at the special immunohistochemistry stain. Most of the adenomyoepithelioma is benign disease, but this case was malignant change. We experienced one case of malignant adenomyoepithelioma of the breast and report the case with review of literatures.
Subject(s)
Adenomyoepithelioma , Breast Neoplasms , Breast , Immunohistochemistry , Korea , Salivary GlandsABSTRACT
We report her on a case of adenoid cystic carcinoma (ACC) associated with adenomyoepithelioma of the breast in a 73-year-old woman. ACC accounts for about 0.1% of all breast cancers. The patient presented with a large, nodular, rubbery mass that measured 5.5x4.0 cm in the subareolar region of the left breast. Light microscopy revealed various growth patterns of ACC with the adenomyoepitheli oma. Immunohistochemically, the epithelial cells in the ACC component reacted strongly for cytokeratin. The myoepithelial cells stained for smooth muscle actin, vimentin and S-100 protein, whereas staining for cytokeratin was weak. The adeno myoepithelioma component showed a similar staining pattern. Reactivity for both estrogen receptor (ER) and progesterone receptor (PR) were negative. There seems to be a spectrum of adeno myoepithelioma-related epithelial and myoepithelial lesions that ranges from low grade to high grade. Therefore, we suggest the present case of ACC arose from an adenomyoepithelioma or there is a close relationship among these combined epithelial and myoepithelial tumors. For both mammary ACC and adenomyoepitheliomas, complete excision with a margin of uninvolved tissue is the recommended treatment. Most of these patients will have an excellent prognosis.
Subject(s)
Aged , Female , Humans , Actins , Adenoids , Adenomyoepithelioma , Breast Neoplasms , Breast , Carcinoma, Adenoid Cystic , Epithelial Cells , Estrogens , Keratins , Microscopy , Muscle, Smooth , Myoepithelioma , Prognosis , Receptors, Progesterone , S100 Proteins , VimentinABSTRACT
Adenomyoepithelioma is a rare benign tumor which occurs mainly in the skin, salivary gland and very rarely in the breast, in case of malignant adenomyoepithelioma of the breast is a rare lesion characterized by malignant proliferation of epithelial and myoepithelial cells that show characteristic histology and immunohistochemical features. We report two cases of adenomyoepithelioma, one was benign occuring in the outer upper quadrant of the right breast (48-year-old female), and the other was malignant adenomyoepithelioma occuring in the peri-areolar of the left breast (46-years-old female). We confirmed with both H&E stain and immunohistochemistry. We report benign and malignant adenomyoepithelioma of the breast occurred in middle aged women.
Subject(s)
Female , Humans , Middle Aged , Adenomyoepithelioma , Breast , Immunohistochemistry , Salivary Glands , SkinABSTRACT
Myoepithelial cells are the normal constituent of mammary gland and the lesions arising from this components are rare and can be divided into three categories. Adenomyoepithelioma, which is one of them, has a characteristics of dual proliferation of epithelial and myoepithelial cells but the biologic behavior of it has not yet been fully understood. Most of the adenomyoepitheliomas are reported in female patients and there are few of male patient reported in English literature. We experienced one case of male adenomyoepithelioma and report the case with review of literature.
Subject(s)
Female , Humans , Male , Adenomyoepithelioma , Mammary Glands, HumanABSTRACT
Adenomyoepithelioma is a rare benign tumor which occurs mainly in the skin, salivary gland and very rarely in the breast. Histologically this tumor demonstrates biphasic differentiation of luminal epithelial cells and myoepithelial cells. We report a case of adenomyoepithelioma occuring in the outer lower quadrant of the right breast of a 56-year-old female, confirmed histologically with an aid of immunohistochemistry. This is the first documented report in Korean literature.