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Published in: Journal of Medical Case Reports 1/2022

Open Access 01-12-2022 | Case report

Adenomyoepithelioma of the breast with unusual confounding diagnostic feature: a case report

Authors: Liqa Al Mulla, Maha Abdelhadi, Afnan Al Muhanna, Tarek Elsharkawy, Areej Al Nemer

Published in: Journal of Medical Case Reports | Issue 1/2022

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Abstract

Background

Adenomyoepithelioma of the breast is an uncommon subtype of breast neoplasm that occurs in adults over a wide age range but most commonly in middle-aged and older adults. It usually presents as a solitary palpable mass or is detected on breast radiographic images. Histologically, it is a biphasic tumor with proliferation of both the epithelial and myoepithelial components of the glands, with variable types of tissue metaplasia.

Case presentation

A 64-year-old Saudi woman who underwent regular breast screening (mammogram) presented to our hospital following radiographic detection of a suspicious grouped microcalcification in the upper outer quadrant of her right breast on the mammogram. A wide local excision of the right breast lump was performed. Following histopathological examination of the breast lump, the final diagnosis was breast adenomyoepithelioma with mucoepidermoid/divergent differentiation, with no evidence of malignancy. About two years after the operation, a clinical follow-up conducted outside our hospital showed the development of ductal carcinoma in situ in the same breast.

Conclusion

Although the prognosis and the plan of treatment remains the same, our case highlights the complexities in making an accurate diagnosis between the various types of metaplasia within adenomyoepithelioma on one hand and the presence of mucoepidermoid differentiation in adenomyoepithelioma on the other.
Literature
1.
go back to reference Hamperl H. The myothelia (myoepithelial cells): normal state; regressive changes; hyperplasia; tumors. Curr Top Pathol. 1970;53:161–220.CrossRef Hamperl H. The myothelia (myoepithelial cells): normal state; regressive changes; hyperplasia; tumors. Curr Top Pathol. 1970;53:161–220.CrossRef
2.
go back to reference Hoon Tan P, Ellis I, Allison K, Borgi E, Fox SB, Lakhani S et al. World Health Organization classification of tumors of breast: adenomyoepithelioma. International Agency for Research on Cancer (IARC). 5th Edition; volume 2. 2019 Hoon Tan P, Ellis I, Allison K, Borgi E, Fox SB, Lakhani S et al. World Health Organization classification of tumors of breast: adenomyoepithelioma. International Agency for Research on Cancer (IARC). 5th Edition; volume 2. 2019
3.
go back to reference Tavassoli FA. Myoepithelial lesions of the breast: myoepitheliosis, adenomyoepithelioma, and myoepithelial carcinoma. Am J Surg Pathol. 1991;15(6):554–68.CrossRef Tavassoli FA. Myoepithelial lesions of the breast: myoepitheliosis, adenomyoepithelioma, and myoepithelial carcinoma. Am J Surg Pathol. 1991;15(6):554–68.CrossRef
4.
go back to reference Ito R, Ota D, Ando S, Mori M, Fukuuchi A. A case of adenomyoepithelioma with myoepithelial carcinoma of the breast. Clin Case Rep. 2019;7(5):930–4.CrossRef Ito R, Ota D, Ando S, Mori M, Fukuuchi A. A case of adenomyoepithelioma with myoepithelial carcinoma of the breast. Clin Case Rep. 2019;7(5):930–4.CrossRef
5.
go back to reference Hayes MM. Adenomyoepithelioma of the breast: a review stressing its propensity for malignant transformation. J Clin Pathol. 2011;64(6):477–84.CrossRef Hayes MM. Adenomyoepithelioma of the breast: a review stressing its propensity for malignant transformation. J Clin Pathol. 2011;64(6):477–84.CrossRef
6.
go back to reference Kim MJ, Kim CS, Ju MJ, Park YS. Malignant adenomyoepithelioma of the breast: A rare case report. Intl J Surg Case Rep. 2019;59:111–4.CrossRef Kim MJ, Kim CS, Ju MJ, Park YS. Malignant adenomyoepithelioma of the breast: A rare case report. Intl J Surg Case Rep. 2019;59:111–4.CrossRef
7.
go back to reference Parikh P, Jameel Z, Falcon S, Rosa M, Kiluk J, Hoover S, et al. Adenomyoepithelioma of the breast: case series and literature review. Clin Imaging. 2021;75:157–64.CrossRef Parikh P, Jameel Z, Falcon S, Rosa M, Kiluk J, Hoover S, et al. Adenomyoepithelioma of the breast: case series and literature review. Clin Imaging. 2021;75:157–64.CrossRef
8.
go back to reference Young RH, Clement PB. Adenomyoepithelioma of the breast. A report of three cases and review of the literature. Am J Clin Pathol. 1988;89:308–14.CrossRef Young RH, Clement PB. Adenomyoepithelioma of the breast. A report of three cases and review of the literature. Am J Clin Pathol. 1988;89:308–14.CrossRef
9.
go back to reference Laforga JB, Aranda FI, Sevilla F. Adenomyoepithelioma of the breast: report of two cases with prominent cystic changes and intranuclear inclusions. Diagn Cytopathol. 1998;19:55–8.CrossRef Laforga JB, Aranda FI, Sevilla F. Adenomyoepithelioma of the breast: report of two cases with prominent cystic changes and intranuclear inclusions. Diagn Cytopathol. 1998;19:55–8.CrossRef
10.
go back to reference Hoda SA, Brogi E, Koerner FC, Rosen PP. Rosen's breast pathology. Fourth edn. Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins; 2014 Hoda SA, Brogi E, Koerner FC, Rosen PP. Rosen's breast pathology. Fourth edn. Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins; 2014
11.
go back to reference Moritz AW, Wiedenhoefer JF, Profit AP, Jagirdar J. Breast adenomyoepithelioma and adenomyoepithelioma with carcinoma (malignant adenomyoepithelioma) with associated breast malignancies: a case series emphasizing histologic, radiologic, and clinical correlation. Breast. 2016;29:132–9.CrossRef Moritz AW, Wiedenhoefer JF, Profit AP, Jagirdar J. Breast adenomyoepithelioma and adenomyoepithelioma with carcinoma (malignant adenomyoepithelioma) with associated breast malignancies: a case series emphasizing histologic, radiologic, and clinical correlation. Breast. 2016;29:132–9.CrossRef
12.
go back to reference Haque W, Verma V, Suzanne Klimberg V, Nangia J, Schwartz M, Brian Butler E, et al. Clinical presentation, national practice patterns, and outcomes of breast adenomyoepithelioma. Breast J. 2020;26(4):653–60.CrossRef Haque W, Verma V, Suzanne Klimberg V, Nangia J, Schwartz M, Brian Butler E, et al. Clinical presentation, national practice patterns, and outcomes of breast adenomyoepithelioma. Breast J. 2020;26(4):653–60.CrossRef
13.
go back to reference Kakkar A, Jangra K, Kumar N, Sharma MC, Mathur SR, Deo SS. Epithelial-myoepithelial carcinoma of the breast: a rare type of malignant adenomyoepithelioma. Breast J. 2019;25(6):1273–5.CrossRef Kakkar A, Jangra K, Kumar N, Sharma MC, Mathur SR, Deo SS. Epithelial-myoepithelial carcinoma of the breast: a rare type of malignant adenomyoepithelioma. Breast J. 2019;25(6):1273–5.CrossRef
14.
go back to reference Moro K, Sakata E, Nakahara A, Hashidate H, Gabriel E, Makino H. Malignantadenomyoepithelioma of the breast. Surg Case Rep. 2020;6(1):118.CrossRef Moro K, Sakata E, Nakahara A, Hashidate H, Gabriel E, Makino H. Malignantadenomyoepithelioma of the breast. Surg Case Rep. 2020;6(1):118.CrossRef
16.
go back to reference Cheng M, Geng C, Tang T, Song Z. Mucoepidermoid carcinoma of the breast: four case reports and review of the literature. Medicine. 2017;96(51): e9385.CrossRef Cheng M, Geng C, Tang T, Song Z. Mucoepidermoid carcinoma of the breast: four case reports and review of the literature. Medicine. 2017;96(51): e9385.CrossRef
17.
go back to reference Fisher ER, Palekar AS, Gregorio RM, Paulson JD. Mucoepidermoid and squamous cell carcinomas of breast with reference to squamous metaplasia and giant cell tumors. Am J Surg Pathol. 1983;7(1):15–27.CrossRef Fisher ER, Palekar AS, Gregorio RM, Paulson JD. Mucoepidermoid and squamous cell carcinomas of breast with reference to squamous metaplasia and giant cell tumors. Am J Surg Pathol. 1983;7(1):15–27.CrossRef
18.
go back to reference Di Tommaso L, Foschini MP, Ragazzini T, Magrini E, Fornelli A, Ellis IO, et al. Mucoepidermoid carcinoma of the breast. Virchows Arch. 2004;444:13–9.CrossRef Di Tommaso L, Foschini MP, Ragazzini T, Magrini E, Fornelli A, Ellis IO, et al. Mucoepidermoid carcinoma of the breast. Virchows Arch. 2004;444:13–9.CrossRef
19.
go back to reference Patchefsky AS, Frauenhoffer CM, Krall RA, Cooper HS. Low-grade mucoepidermoid carcinoma of the breast. Arch Pathol Lab Med. 1979;103:196–8.PubMed Patchefsky AS, Frauenhoffer CM, Krall RA, Cooper HS. Low-grade mucoepidermoid carcinoma of the breast. Arch Pathol Lab Med. 1979;103:196–8.PubMed
Metadata
Title
Adenomyoepithelioma of the breast with unusual confounding diagnostic feature: a case report
Authors
Liqa Al Mulla
Maha Abdelhadi
Afnan Al Muhanna
Tarek Elsharkawy
Areej Al Nemer
Publication date
01-12-2022
Publisher
BioMed Central
Published in
Journal of Medical Case Reports / Issue 1/2022
Electronic ISSN: 1752-1947
DOI
https://doi.org/10.1186/s13256-022-03507-3

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