Li Jie Xiao, Zhang Xi Meng, Xiao Yun Xiao, Tang Zi Mei, Huang Tao, Ming Jie
Department of Breast and Thyroid Surgery, Union Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan 430022, China.
J Med Cases. 2021 Dec;12(12):503-510. doi: 10.14740/jmc3790. Epub 2021 Dec 2.
Adenoid cystic carcinoma (ACC) of the breast, a rare malignancy that makes up less than 0.1% of all breast malignancies, is much rarer in males than in females. Due to the rarity of this disease, an optimal treatment strategy for male breast ACC has not been established, and therapy for male patients is currently based on guidelines for female patients. According to previous reported cases, some authors believe that male breast ACC may have higher invasive potential than female breast ACC and the prognoses in male patients may be worse than those in female patients. Therefore, a more proactive diagnosis and treatment regimen may be required. However, the clinical feature of our case is inconsistent with this view. Herein we report the case of a 24-year-old male without any antecedent medical or family history who presented with a slow-growing lump on his left chest wall for 5 years. The patient initially underwent lumpectomy, and the mass was pathologically diagnosed as breast ACC. Systemic examination was performed, and no evidence of distant metastasis was found. Then, he received modified radical mastectomy and ipsilateral axillary lymph node dissection. The mastectomy pathological examination revealed that no cancerous tissue was detected around the primary tumor bed, and all 22 axillary lymph nodes were negative. The patient did not receive postoperative chemotherapy, radiotherapy or endocrine therapy and remained well after 28 months of follow-up. In this study, we review the literature and summarize the clinical manifestations, imaging and histopathological characteristics, treatments and outcomes of male breast ACC. We share our experience in the hopes that this evidence will aid in the development of better therapeutics.
乳腺腺样囊性癌（ACC）是一种罕见的恶性肿瘤，在所有乳腺恶性肿瘤中占比不到0.1%，在男性中比在女性中更为罕见。由于这种疾病的罕见性，尚未确立针对男性乳腺ACC的最佳治疗策略，目前男性患者的治疗是基于女性患者的指南。根据先前报道的病例，一些作者认为男性乳腺ACC可能比女性乳腺ACC具有更高的侵袭潜能，男性患者的预后可能比女性患者更差。因此，可能需要更积极的诊断和治疗方案。然而，我们病例的临床特征与这一观点不一致。在此，我们报告一例24岁男性病例，该患者无任何既往病史或家族病史，左侧胸壁出现缓慢生长的肿块5年。患者最初接受了肿块切除术，肿块经病理诊断为乳腺ACC。进行了全身检查，未发现远处转移的证据。然后，他接受了改良根治性乳房切除术和同侧腋窝淋巴结清扫术。乳房切除术后病理检查显示，在原发肿瘤床周围未检测到癌组织，所有22枚腋窝淋巴结均为阴性。患者未接受术后化疗、放疗或内分泌治疗，随访28个月后情况良好。在本研究中，我们回顾了文献并总结了男性乳腺ACC的临床表现、影像学和组织病理学特征、治疗方法及结果。我们分享我们的经验，希望这些证据将有助于开发更好的治疗方法。
