Hikino Hajime, Kodama Koji, Yasui Kiyoshi, Ozaki Nobuhiro, Nagaoka Saburo, Miura Hiroshi
Department of Surgery, Shimane Prefectural Central Hospital, Shimane, Japan.
Breast Cancer. 2007;14(4):429-33. doi: 10.2325/jbcs.14.429.
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.
本文描述了1例酷似囊内癌的乳腺囊内腺肌上皮瘤病例。术前通过乳腺X线摄影、超声、计算机断层扫描和磁共振成像检查发现一个囊内肿瘤,边界不清,同侧腋窝有多个肿大淋巴结。由于肿瘤细针穿刺细胞学检查结果被诊断为癌,遂行保乳手术并清扫腋窝淋巴结。组织病理学和免疫组化检查显示为囊内腺肌上皮瘤,无淋巴结受累。这种罕见肿瘤的影像学特征可能差异很大,这可能导致对乳腺癌的误诊。事实上,腺肌上皮瘤具有转移潜能;然而,淋巴转移很少见,对大多数病例而言腋窝干预可能属于过度治疗。虽然关于囊内腺肌上皮瘤的影像学描述非常有限,但在鉴别诊断时应考虑到这种肿瘤,以避免不必要的积极治疗。