Department of Medical-Surgical Sciences and Biotechnologies, Histopathology Unit, Polo Pontino - Sapienza University of Rome, Latina, Italy.
World J Surg Oncol. 2013 Oct 30;11:285. doi: 10.1186/1477-7819-11-285.
Breast adenomyoepithelioma is an unusual tumor characterized by a biphasic proliferation of epithelial and myoepithelial cells. Most breast adenomyoepitheliomas are considered to be benign or to have a low-grade malignant potential, characterized by propensity for local recurrence. Malignant changes arising in this lesion are extremely rare and may involve one or both cellular components.
We discuss a case of a 60 year-old woman who began to experience pain in her right breast in January 2009. Breast ultrasound and mammography were performed showing a rounded, hypoechoic solid lesion with ill-defined margins in the right inner-inferior quadrant, suspicious of malignancy. Quadrantectomy of the inner-inferior quadrant of the right breast with sampling of ipsilateral axillary lymph nodes was performed. The histological analysis confirmed the diagnosis of adenomyoepithelioma with focal malignant change of the epithelial component, associated with high-grade malignant myoepithelial change. The patient was treated with adjuvant radiotherapy and her right breast received a dose of Gy 50 with a boost of Gy 10 to the tumor bed. At present, the patient shows no sign of tumor recurrence.
Breast malignant adenomyoepithelioma is a rare tumor which should be considered in the differential diagnosis of other solid breast lesions. Only few cases have been reported in the literature. Diagnosis, optimal therapy and predicting the outcome are problematic issues due to the rarity of this disease which appears to have hematogenous rather than lymphatic spread and usually occurs in primary tumors ≥ 1.6 cm in size.
乳腺腺肌上皮瘤是一种不常见的肿瘤，其特征是上皮细胞和肌上皮细胞的双相增殖。大多数乳腺腺肌上皮瘤被认为是良性的或具有低度恶性潜能，其特征是倾向于局部复发。这种病变中发生的恶性变化极为罕见，可能涉及一个或两个细胞成分。
我们讨论了一名 60 岁女性的病例，她于 2009 年 1 月开始出现右侧乳房疼痛。乳房超声和乳房 X 线摄影显示右侧内下象限有一个圆形、低回声实性病变，边界不清，可疑为恶性。对右侧内下象限进行象限切除术，并对同侧腋窝淋巴结进行取样。组织学分析证实了腺肌上皮瘤的诊断，上皮成分有局灶性恶性变化，伴有高级别恶性肌上皮变化。患者接受了辅助放疗，右侧乳房接受了 50Gy 的剂量，并对肿瘤床进行了 10Gy 的增量照射。目前，患者没有肿瘤复发的迹象。
乳腺恶性腺肌上皮瘤是一种罕见的肿瘤，在鉴别诊断其他实性乳腺病变时应考虑到这种肿瘤。在文献中仅报道了少数几例。由于这种疾病的罕见性，其诊断、最佳治疗和预测预后都是有问题的，这种疾病似乎是血源性而不是淋巴转移，并且通常发生在原发性肿瘤≥1.6cm 的情况下。
