Nakamura Kayo, Nio Yoshinori, Imai Shiro, Sakamoto Marika, Sakamoto Takashi, Kamei Masako, Maruyama Riruke, Soh Hiroyuki
Nio Breast Surgery Clinic.
Gan To Kagaku Ryoho. 2024 Jul;51(7):757-761.
Adenomyoepithelioma(AME)of the breast is a rare condition, and comorbidity with carcinoma is even more unusual. Herein, we report a case of both AME and apocrine carcinoma in different breasts of a single patient. A 48-year-old woman presented to our clinic with a right breast tumor. Fine needle aspiration cytology(FNAC)was indeterminate and suspicious for both papilloma and non-invasive ductal carcinoma, but excisional biopsy indicated an AME. Immuno-histochemical staining showed EMA(+), AE1/3(+), and CK7(+)mammary duct cells and αSMA(+), CK5/6(+), and p63(+) myoepithelial cells. Six months later, the patient noticed a left breast tumor, and although FNAC indicated no malignancy, after 6 additional months, the tumor size had increased and a mammography revealed tumor microcalcification, suggesting malignancy. Vacuum-assisted biopsy revealed an apocrine carcinoma. The patient underwent partial mastectomy and sentinel node biopsy, followed by radiotherapy and chemotherapy. The post-surgical pathology was pT1pN0M0, Stage Ⅰ, triple- negative, and the patient was disease-free for 12 years postoperatively. To our knowledge, this is only the second case of AME and breast cancer in different breasts reported in Japan.
乳腺腺肌上皮瘤（AME）是一种罕见疾病，合并癌更为少见。在此，我们报告一例单例患者双侧乳房分别患有AME和大汗腺癌的病例。一名48岁女性因右乳肿物就诊于我院。细针穿刺细胞学检查（FNAC）结果不明确，怀疑为乳头状瘤和非浸润性导管癌，但切除活检显示为AME。免疫组化染色显示乳腺导管细胞EMA（+）、AE1/3（+）、CK7（+），肌上皮细胞αSMA（+）、CK5/6（+）、p63（+）。6个月后，患者发现左乳肿物，尽管FNAC未提示恶性，但又过了6个月，肿瘤增大，乳腺钼靶显示肿瘤微钙化，提示恶性。真空辅助活检显示为大汗腺癌。患者接受了保乳手术和前哨淋巴结活检，随后进行了放疗和化疗。术后病理为pT1pN0M0，Ⅰ期，三阴性，患者术后无病生存12年。据我们所知，这是日本报道的第二例双侧乳房分别患有AME和乳腺癌的病例。
