Pathologic quiz case: A rapidly increasing breast mass in a postmenopausal woman. Malignant adenomyoepithelioma

Department of Pathology, New York Presbyterian Hospital-Weill Medical College of Cornell University, New York, NY 10021, USA.
Archives of pathology & laboratory medicine (Impact Factor: 2.84). 03/2004; 128(2):235-6. DOI: 10.1043/1543-2165(2004)128<235:PQCARI>2.0.CO;2
Source: PubMed
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    ABSTRACT: Adenomyoepithelioma (AME) of the breast is an uncommon tumor characterized by biphasic proliferation of both epithelial and myoepithelial cells. In rare instances, the epithelial, the myoepithelial or both components of an AME may become malignant. Described herein is the case of a 69-year-old woman who presented with myoepithelial carcinoma of the breast in an AME. Malignancy of myoepithelial component (MEC) was evidenced by the presence of cytological atypia, high mitotic rate, necrosis and local invasion. Immunohistochemical study demonstrated strong expression of P53 and phosphorylated extracellular signal-regulated kinase 1/2 in MEC. Laser capture microdissection technique and mutational analysis further revealed point mutation of the p53 gene (T-->G transversion at codon 270) in this population, but not in glandular epithelial cells or adjacent normal ductal epithelium. No mutations in exons 1 and 2 of the K-, H-, and N-ras genes were identified in any of the neoplastic component. To the authors' knowledge this is the first report of a mutation in the p53 gene in a malignant AME of the breast.
    Pathology International 05/2006; 56(4):211-6. DOI:10.1111/j.1440-1827.2006.01948.x · 1.69 Impact Factor
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    ABSTRACT: BACKGROUND: Adenomyoepithelioma (AME) of the breast is a biphasic very uncommon tumour with epithelial/ my-oepithelial components. It can be easily recognised in an excised lesion, but it is more difficult to make a definitive diagnosis with needle biopsy. CASE REPORT: We report the case of a 42-year-old woman who presented with a mass in her right breast. The patient underwent a fine needle aspiration, and a diagnosis of C5 carcinoma was made. Neoadjuvant treatment was proposed to the patient but she refused and was referred to a third level centre where a needle core biopsy was performed and a diagnosis suggestive of AME was made. CONCLUSION: If there is cytological atypia, AME may be confused with infiltrating ductal carcinoma in needle biopsies because of limited tissue sampling.
    Breast Care 04/2008; 3(2):125-127. DOI:10.1159/000119727 · 0.63 Impact Factor
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    ABSTRACT: Presented herein is the first case of malignant adenomyoepithelioma (malignant AME) of the breast combined with invasive lobular carcinoma (ILC) in a 53-year-old woman. Histologically, the tumor was composed of nodular proliferation of biphasic epithelial and myoepithelial carcinoma, partially surrounded by ILC. Interestingly, ILC metastasized to the axillary lymph nodes, while biphasic epithelial and myoepithelial carcinoma hematogenously metastasized to the lung and the kidney. On immunohistochemistry the biphasic carcinoma consisted of cytokeratin (CK) 8/18-positive/CK5/6-positive/smooth muscle actin (SMA)-negative inner carcinoma cells and CK8/18-positive/CK5/6-positive/SMA-positive outer carcinoma cells. The monophasic ILC cells had a CK8/18-positive/CK5/6-negative/SMA-negative staining pattern. Although it is unclear whether both ILC and biphasic epithelial and myoepithelial carcinoma originated from AME or whether ILC occurred independently of malignant AME, this is an exceptionally rare case, which might give rise to a special consideration of the histogenesis of breast cancer.
    Pathology International 04/2009; 59(3):179-84. DOI:10.1111/j.1440-1827.2009.02347.x · 1.69 Impact Factor
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