Intracystic adenomyoepithelioma of the breast — case report and review

Abstract

A case of an intracystic adenomyoepithelioma of the breast mimicking intracystic carcinoma is described. Preoperative examination with mammography, sonography, computed tomography, and magnetic resonance imaging showed an intracystic tumor with an indistinct margin and several swollen lymph nodes in the ipsilateral axilla. Because the results of fine-needle aspiration cytology of the tumor were interpreted as carcinoma, partial mastectomy with dissection of the axillary nodes was performed. Histopathologic and immunohistochemical examination revealed an intracystic adenomyoepithelioma without nodal involvement. The imaging features of this rare tumor may vary widely, which may result in an incorrect diagnosis of breast carcinoma. Indeed, adenomyoepithelioma has metastatic potential; however, lymphatic spread is rare and axillary intervention may be over-treatment for most cases. While the imaging descriptions of intracystic adenomyoepitheliomas are very limited, this tumor should be considered in the differential diagnosis to avoid unnecessarily aggressive treatment.

Adenomyoepithelioma with Ductal Carcinoma In Situ: A Case Report and Review of the Literature

“…Wide local excision with clear margins is generally recommended but the degree of margins required is unknown as some cases of AME show rapid local recurrences [13]. However, AMEs demonstrate a propensity for haematogenous rather than nodal spread, and it has previously been proposed that SNLB or axillary dissection can lead to overtreatment [14]. …”

Ultrasonographic Features of Benign Adenomyoepithelioma of the Breast

“…Nonspecific MRI findings cases of a benign adenomyoepithelioma that mimicked malignancy are extremely rare (9, 12). To the best of our knowledge, no reports about PET/CT findings for the adenomyoepithelioma have been documented.…”

“…Three cases with solid masses (60%) showed duct dilatation around the mass. This finding might be caused by the neoplastic proliferation of the adenomyoepithelioma compressed or obstructed in the adjacent duct space (12). …”

Adenomioepitelioma de la Mama: Reporte de un Caso

“…El estudio inmunohistoquímico con positividad para actina músculo liso (SMA), p63 y CD10 demuestra la proliferación de células mioepiteliales mientras que citoqueratina 5/6 (CK 5/6) y antígeno carcinoembrionario (CEA) son positivos en el componente epitelial ductal (Chu et al;Catena et al;Tavassoli;Hikino et al, 2007;Choi et al, 1996). El caso descrito presentó un patrón tubular, con márgenes bien definidos y positividad para SMA (Figura 1D) en el estudio inmunohistoquímico.…”

“…Por el contrario para lesiones sospechosas de malignidad se recomienda realizar estudio histopatológico intraoperatorio para confirmar la naturaleza de la lesión y realizar de esta manera una resección con criterio oncológico que incluya disección axilar o estudio del linfonodo centinela y posterior estudio de diseminación, reportando la literatura metástasis en cinco casos que presentaron compromiso de nodos linfáticos regional, óseo (costilla, mandíbula y columna lumbar), pulmonar y cerebral (Catena et al;Foschini & Eusebi;Chu et al;Hikino et al;Loose et al;Tavassoli;Chen et al, 1994).…”