Adenomyoepithelioma A Rare Breast Tumor: Case Studies With Review Of The Literature

摘要

Introduction : Adenomyoepithelioma is a rare, benign proliferative tumor that can involve the breast tissue. The diagnostic appearance of the lesion can give rise to a difficult differential diagnosis with breast carcinoma. There is the potential for malignant evolution of this lesion. It usually presents as a solitary, unilateral, painless mass at the periphery of the breast. Accurate diagnosis and differentiation from more aggressive tumors is important. Materials and methods :In two cases of breast lumps, fine needle aspiration cytology (FNAC) was done and stained with H & E and Papanicolaou stains. The formalin-fixed tissue sections were stained with hematoxylin and eosin and in one case, immunohistochemistry was performed with smooth muscle actin (SMA).Case 1: A 30-year-old female presented with a firm lump in the upper quadrant of the right breast along with axillary lymphadenopathy since 6 months. On ultrasound it was reported as duct ectasia. FNAC was suggestive of proliferative breast disease with atypia (possibility of duct cell carcinoma). Modified radical mastectomy was done and sent for histopathology. The histopathological diagnosis was adenomyoepithelioma – breast (right), tubular type.Case 2: A 25-year-old female presented with a firm lump in the left breast, occupying all quadrants. On FNAC the aspirates were suggestive of fibroadenoma. Peroperatively it was found to be a cystic swelling occupying the whole breast. The mass was excised and sent for histopathology. The histopathological diagnosis was adenomyeoepithelioma with apocrine metaplasia and cystic degeneration -– breast (left), tubular type.Results : Two cases of breast lump were managed surgically. Both the cases were females with the mean age being 27 years. Both cases were of adenomyoepithelioma (tubular type) with one case showing apocrine metaplasia and cystic change. Conclusion : Prognosis of patients with benign adenomyoepithelioma of the breast is usually good, but it has a potential for local recurrence, especially in the tubular and lobulated variants. Total surgical excision with an adequate margin of uninvolved breast tissue is therefore recommended. Introduction Benign adenomyoepithelioma of the breast is a rare tumor characterized by biphasic proliferation of both an inner layer of epithelial cells and a prominent peripheral layer of myoepithelial cells. It was first described by Hamperl[1] in 1970; more than 60 cases have been reported since then. All cases except 2 occurred in females.[2,3] Benign adenomyoepitheliomas outnumber their malignant counterparts by far. Malignancy may arise either through malignant transformation of 1 of the 2 cellular components or through malignant transformation of both.[4] The difficult differential diagnosis, potential for recurrence and malignant evolution of this lesion merit a careful approach. Materials and methods In two cases of breast lump, FNAC was done and stained with H & E and Papanicolaou stains. The formalin-fixed tissue sections were stained with hematoxylin and eosin, and in one case immunohistochemistry was performed with smooth muscle actin (SMA). Case 1:A 30-year-old female presented with a firm lump in the upper quadrant of the right breast along with axillary lymphadenopathy since 6 months. On ultrasound it was reported as duct ectasia. FNAC was suggestive of proliferative breast disease with atypia (possibility of duct cell carcinoma) (Figure 1, 2).