Rationale: Mucoepidermoid carcinoma (MEC) of the breast is a rare entity, with an estimated incidence of only 0.2% to 0.3% of all primary breast tumors. The radiological features of breast MEC have scarcely been investigated mainly because of its rarity. In this article, we present a case of breast MEC diagnosed at our hospital and review the literature, focusing on radiological findings and radiologic–pathologic correlations that could improve clinical management of this entity. To the best of our knowledge, our study is the first review of the literature that focuses on the radiological features of breast MEC. Patient concerns: A 47-year-old premenopausal woman presented with a painless palpable mass in the right breast. Diagnosis: Mammography and ultrasonography revealed a mass with suspicious malignant features, which was categorized as Breast Imaging Reporting and Data System category 4c. A 14-gauge core-needle biopsy revealed an intermediate-grade MEC of the breast. The patient underwent breast magnetic resonance imaging and chest computed tomography for preoperative evaluation. Postoperative histopathological examination confirmed a diagnosis of intermediate-grade MEC. The clinical staging was T2N0M0. Interventions: The patient underwent breast-conserving surgery, adjuvant chemotherapy, radiotherapy, and hormonal therapy. Outcomes: No evidence of recurrence has been reported over 37 months. Lessons: The imaging characteristics of breast MEC were variable, and there were no specific radiological features for diagnosis. The presence of cystic components on radiological imaging is likely to be an indicator of a low-grade tumor and better prognosis, although the number of reported cases is limited.
Purpose: The aim of this multicenter study was to investigate the malignancy risk of minimally cystic thyroid nodules (MCTNs) using cyto-histopathologic diagnoses as the reference standard.Methods: From June 2015 to September 2015, 5,601 thyroid nodules (≥1 cm) from 4,989 consecutive patients who underwent thyroid ultrasonography (US) at 26 institutions were retrospectively analyzed. Each thyroid nodule was categorized according to its cystic proportion: purely solid, minimally cystic (≤10%), and partially cystic (>10%). The malignancy risk of MCTNs was compared with those of purely solid nodules and partially cystic thyroid nodules (PCTNs). The malignancy risk of MCTNs was assessed according to echogenicity and the presence of suspicious US features.Results: The prevalence of MCTNs was 22.5%. The overall malignancy risk of MCTNs was 8.8%, which was significantly lower than that of purely solid nodules (29.5%) (P<0.001), and slightly higher than that of PCTNs (6.2%) (P=0.013). The risk of malignancy associated with MCTNs was similar to that of PCTNs regardless of echogenicity or the presence of suspicious US features (all P>0.05). MCTNs were associated with a higher risk of malignancy in hypoechoic nodules than in isohyperechoic nodules and in nodules with suspicious US features than in those without suspicious US features (all P<0.001).Conclusion: The malignancy risk of MCTNs was significantly lower than that of purely solid nodules. MCTNs could be categorized as PCTNs rather than as solid nodules to increase the accuracy of the risk stratification system for thyroid nodules.
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