Histopathological and immunohistochemical characteristics of malignant adenomyoepithelioma in a cat: case report / [Características histopatológicas e imuno-histoquímicas do adenomioepitelioma maligno em gata: relato de caso]

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)

Adenomioepitelioma benigno de mama. Reporte de caso y revisión de la literatura / Benign breast adenomyoepithelioma. Case report and literature review / Adenomioepitelioma benigno de mama. Reporte de caso e revisão da literatura

Los adenomioepiteliomas de mama son tumores inusuales caracterizados por la proliferación bifásica de células epiteliales y mioepiteliales. Aunque la mayoría son benignos, tienen riesgo de recurrencia local y los casos con transformación maligna pueden tener riesgos de metástasis. El diagnóstico clínico e imagenológico no tiene rasgos característicos y en general se requiere de la resección completa de la lesión, para estudio microscópico y apoyo en la inmunohistoquímica. Al haber riesgo de recidiva local se recomienda resección con márgenes amplios. Para esta revisión se utilizó como fuente primaria de información la historia clínica y se realizó una búsqueda de la literatura relacionada con el uso de las palabras breast y adenomyoepithelioma, en la base de datos Pubmed, durante los últimos 10 años, en inglés y español, para discutir los aspectos relacionados con el tema.

The breast adenomyloepithelioma is an unusual tumor characterized by the biphasic proliferation of epithelial and myoepithelial cells. Although most of these tumors are benign, they may be at risk of local recurrence and few cases with malignant transformation may have chances of metastasis. The clinical and imaging diagnosis has no characteristic features and, in general, a complete resection of the lesion is required for microscopic study and support in immunohistochemistry. When risk of local recurrence is present, a resection with wide margins is recommended. The clinical history was the primary source of information on the case and, as a complement, there was a literature search, in both English and Spanish, focused on the use of the words "Breast" and "Adenomyoepithelioma" and was retrieved from Pubmed database publications from the last 10 years.

Os adenomioepiteliomas de mama são tumores incomum caracterizados pela proliferação bifásica de células epiteliais e mioepiteliais. Ainda que a maioria são benignos, tem risco de recorrência local e os casos com transformação maligna podem ter riscos de metástase. O diagnóstico clínico e de imagem não tem traços característicos e em geral se requere da ressecção completa da lesão, para estudo microscópico e apoio na imuno-histoquímica. Ao haver risco de recidiva local se recomenda ressecção com margens amplas. Para esta revisão se utilizou como fonte primária de informação a história clínica e se realizou una busca da literatura relacionada com o uso das palavras breast e adenomyoepithelioma, na base de dados Pubmed, durante os últimos 10 anos, em inglês e espanhol, para discutir os aspectos relacionados com o assunto.

Malignant transformation in a Breast Adenomyoepithelioma Caused by Amplification of c-MYC: A Common pathway to Cancer in a Rare Entity / 한국유방암학회지

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.

Adenomioepitelioma de mama. Presentación de un caso / Adenomyoepithelioma of the breast. A case presentation

RESUMEN El adenomioepitelioma es un tumor de la mama poco frecuente, generalmente de comportamiento benigno, de histología variable, que puede simular otras lesiones epiteliales, mioepiteliales y bifásicas de la mama. Patológicamente es un desorden raro caracterizado por la proliferación simultánea de las células del epitelio ductal y células mioepiteliales. Es más común en las glándulas salivales o en la piel, raras veces es encontrado en el tejido mamario. Afecta fundamentalmente al sexo femenino, alrededor de los 50 años de edad. Clínicamente se presenta por una pequeña masa palpable que ocupa cuadrantes centrales de la mama. El tratamiento de elección es la exéresis amplia de la lesión. Es frecuente la recidiva local y en algunas ocasiones puede tener degeneración maligna. Se presentó una paciente 13 años de edad, que acudió al Servicio de Cirugía del Hospital "Dr. Mario Muñoz Monroy" , municipio Colón, provincia de Matanzas con un tumor de consistencia dura; pero no pétreo, de 8-10 cm de diámetro, en cuadrantes inferiores y región retroareolar de la mama derecha. El estudio sonográfico informó la presencia de una imagen hipoecoica, de forma oval. Se realizó exéresis de la lesión. El estudio patológico e inmunohistoquímico aportó un adenomioepitelioma de la mama. La paciente no presentó complicaciones postoperatorias. Actualmente se sigue por consulta a 7 años de la cirugía.

ABSTRACT Adenomyoepithelioma is a very rare and generally benign tumor of varying histology that can simulate other epithelial, myoepithelial and biphasic lesions of the breast. Pathologically it is rare disorder characterized by the simultaneous proliferation of ductal epithelium and myoepithelial cells. It is more common in salivary glands and in skin. Rarely found in mammal tissue, it mainly affects women, aged around 50 years, and clinically presents like a palpable mass occupying central breast quadrants. The treatment of choice is the extensive excision of the lesion. Local recidivisms is very frequent, and sometimes they could have malignant degeneration. The authors present the case of a female patient, aged 13 years, who assisted the service of Surgery of the Hospital "Dr. Mario Muñoz Monroy", municipality of Colon, province of Matanzas with a tumor of hard consistence, of 8-10 cm diameter, in lower quadrants and retro alveolar region of the right mamma. The sonographic study informed the presence of a hypoechoic, oval image. The lesion was excised. The pathological and immunohistochemical study showed a breast adenomyoepithelioma. The patient did not have post-surgery complications. Currently she is followed in consultation after seven years of the surgery.

Adenomyoepithelioma of the Breast: Which Mimicking Malignancy on Ultrasound Elastography

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.

Malignant Adenomyoepithelioma of the Breast and Responsiveness to Eribulin / 한국유방암학회지

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.

Adenomyoepithelioma Located Over the Tibial Tuberosity

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.

Metaplastic Carcinoma with an Adenomyoepithelioma Component : A Case Report

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.

Adenomyoepithelioma with malignant transformation diagnosed by immunohistochemical analysis: case report / Adenomioepitelioma com transformações malignas diagnosticado por imuno-histoquímica: relato de caso

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.

Adenomioepitelioma de la mama: reporte de un caso / Adenomyoepithelioma of the breast: a case report

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.

Myoepithelial carcinoma with contralateral invasive micropapillary carcinoma of the breast / 대한외과학회지

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.

Ultrasonographic Features of Benign Adenomyoepithelioma of the Breast

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.

Malignant Adenomyoepithelioma of the Breast Presenting as a Large Mass that Grew Slowly without Metastasis / 한국유방암학회지

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.

Malignant Adenomyoepithelioma of the Breast

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.

Adenoid Cystic Carcinoma of the Breast associated with Adenomyoepithelioma / 한국유방암학회지

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.

The Breast Adenomyoepithelioma

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.

Cystic Adenomyoepithelioma of the Breast: A Case Report

Adenomyoepithelioma of the female breast is a rare tumor. With rare exceptions, the tumor is uniformly solid. We describe a large grossly cystic adenomyoepithelioma in a 67-year-old female. The tumor was histologically benign. The characteristic microscopic finding was the proliferation of rounded tubules lined by both epithelial and myoepithelial cells. Immunohistochemical findings confirmed the presence of two cell population.

Mammographic & Sonographic findings of Adenomyoepithelioma of the Breast: Case Report

Adenomyoepithelioma is very rare. Because of its rarity, adeonomyoepithelioma may present a diagnostic challenge to the radiologists and there is a little information on the diagnosis and treatment of this condition. I report on two patients with benign and malignant adenomyoepitheliomas which represent breast masses on mammograms and ultrasonograms. The diagnosis was confirmed by immunohistochemical study of the resected specimens.

Report of Benign and Malignant Adenomyoepithelioma of the Breast / 한국유방암학회지

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.