Reporting a Rare Case of Pleomorphic Adenoma of the Breast

Abstract

Pleomorphic adenoma (PA) is the most common tumor type in the salivary gland. PA is uncommon in the breast tissue. Only 73 cases of PA of the breast have been reported in the world literature. We are reporting the 74th case of PA of the breast. A 61-year-old woman was referred to Shahid Beheshti Hospital Obstetric Clinic with bloody painless discharge from the right nipple. A bean size mass was detected immediately below the right nipple. After an excisional biopsy, the pathologist found proliferation in epithelial and myoepithelial cells that had small and multiple nuclei, myxoid and chondroid stroma. Immunohistochemistry stain was positive for S-100 and patchy for GFAP in tumor cells and for SMA around the tubule-glandular and tumor cell aggregates and suggested PA of the breast. It is essential for the pathologists to consider PA of the breast as a differential diagnosis of a rounded circumscribed mass in the juxta-areolar areas. Careful paraffin sections should be performed to avoid an unnecessary mastectomy.

Benign mixed tumour of the breast and breast skin, two cases with diagnostic difficulties

“…It shows a tendency to locate in the subareolar/periareolar region of the breast 10. The tumour sizes ranged from 0.6 to 17 cm with a mean diameter of 2 cm 5. Both our patients were also postmenopausal women and presented as palpable, non-tender and nodular lesions.…”

“…It is noteworthy that most of the PA cases reported have been in the subareolar–periareolar region of the breast 5 10. This suggests that the tumour originates from the large ducts.…”

“…It occurs less frequently in other sites such as skin (chondroid syringoma), larynx, lung, lacrimal gland and breast. Less than hundred cases of PA of the breast have been reported in the literature, mostly in the form of single case reports3 5 and a few case series including a maximum of 10 cases 6–8. Since it is rare in the breast and breast skin, it is possible to misinterpret it as a malignant tumour during clinical and radiological evaluations 9.…”

“…Most of the cases of PA were reported in women; however, three cases were of men with an age ranging between 23 and 85 years 5. The majority of the women were postmenopausal.…”

Pleomorphıc Adenoma Of The Breast, A Rare Case Report

“…Pleomophic adenomas may also occur at other sites including the larinx, paranasal sinuse palete, nasal septum, vulva, and skin (chondroid syringoma) 2 . Pleomorphic adenoma of the breast is rare, and to date only 74 cases have been documented in the world literature 1 .…”