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Benign, metastasizing adenomyoepithelioma of the breast: a report of 2 cases

Department of Pathology and Laboratory Medicine, David Geffen School of Medicine at UCLA, Los Angeles, Calif 90095, USA.
Archives of pathology & laboratory medicine (Impact Factor: 2.88). 10/2006; 130(9):1349-53. DOI: 10.1043/1543-2165(2006)130[1349:BMAOTB]2.0.CO;2
Source: PubMed

ABSTRACT Adenomyoepitheliomas of the breast are rare tumors composed of a proliferation of 2 cell populations. For the most part, they are considered to be benign, but they locally recur. Those neoplasms that metastasize are deemed to have come from a histologically malignant primary tumor. Herein, we describe 2 cases of metastases of histologically "benign" adenomyoepitheliomas of the breast to the lung. In both cases, the primary neoplasms and the metastases did not show histologic features of malignancy. These unique cases represent another example of neoplasms that can metastasize in the absence of histologic features that would suggest malignant behavior. Establishing the diagnosis, determining optimal therapy, and predicting outcome are problematic because of the rarity of this entity. Perhaps, classification of adenomyoepitheliomas should be changed to recognize those neoplasms with malignant behavior.

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    • "Although it is difficult to reach a conclusion concerning the degree of malignancy, extirpation of the tumor may be recommended owing to the tendency to develop breast cancer or malignant adenomyoepithelioma (Tsuda et al. 1994; Kiaer et al. 1984), if the preoperative diagnosis of adenomyoepithelial adenosis is performed using needle biopsy . As two cases recurred after excisional biopsy (Kiaer et al. 1984; Erel et al. 2008), re-excision may be recommended in cases of suspected inadequate margin, like adenomyoepithelioma (Nadelman et al. 2006). The best predictors of recurrence are initial incomplete or close excision margins. "
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    ABSTRACT: Adenomyoepithelial adenosis of the breast is an extremely rare type of adenosis. We herein present the case of a 35-year-old woman, who presented with a small painless hard lump and elastic soft induration of 5 cm in diameter in her left breast. Clinical examination and diagnostic workup were suggestive of a breast carcinoma, and a modified radical mastectomy and sentinel node biopsy were performed. Histopathological examination revealed adenomyoepithelial adenosis along with fibrocystic change and small invasive ductal carcinoma, slightly away from the adenosis. The presented case was thought to be initial-stage adenomyoepithelial adenosis and independently developing breast cancer. From a review of five reported cases of adenomyoepithelial adenosis, complete resection of the tumor and coexisting malignant disease may be recommended, owing to the tendency to develop breast cancer or malignant adenomyoepithelioma, or recurrence.
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    ABSTRACT: BACKGROUND: Myoepithelial cells are widely present in the breast, and their hyperplasia may result in a spectrum of disease ranging from myoepitheliosis to myoepithelial carcinoma. CASE REPORT: A 46-year-old woman presented with a palpable mass in her right breast. Mammography and ultrasonography showed a lesion in the upper quadrant of the right breast with spiculated borders and shape. Excisional biopsy showed adenomyoepithelial adenosis. CONCLUSIONS: Although considered benign, adenomyoepithelial lesions tend to recur due to inadequate excision. Therefore, possibility of recurrence and even metastasis should be considered during follow-up of patients with a diagnosis of adenomyoepithelial lesions.
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