J Korean Soc Radiol.  2015 Jun;72(6):411-417. 10.3348/jksr.2015.72.6.411.

Radiologic and Pathological Correlation of Adenoid Cystic Carcinoma of the Breast: A Case Report

Affiliations
  • 1Department of Radiology, Soonchunhyang University College of Medicine, Cheonan Hospital, Cheonan, Korea. taloo@hanmail.net
  • 2Department of Pathology, Soonchunhyang University College of Medicine, Cheonan Hospital, Cheonan, Korea.
  • 3Department of Surgery, Soonchunhyang University College of Medicine, Cheonan Hospital, Cheonan, Korea.
  • 4Department of Radiology, Plus Internal Medicine Clinic, Suncheon, Korea.

Abstract

Adenoid cystic carcinoma (ACC) is a subtype of adenocarcinoma that is usually seen in the salivary glands. It has also been reported in other organs including the breast, skin, tracheobronchial tree, cervix, larynx, and Bartholin gland. ACC in the breast is rare, accounting for less than 0.1% of all breast cancers. Furthermore, the imaging characteristics of ACC of the breast have not been well described in the literature, especially regarding the findings with magnetic resonance imaging (MRI). Here, we report radiologic findings of a rare case of ACC in the breast by mammography, sonography, computed tomography (CT), positron emission tomography/CT, and MRI with pathologic correlation and a review of the literature.


MeSH Terms

Adenocarcinoma
Breast*
Carcinoma, Adenoid Cystic*
Cervix Uteri
Electrons
Female
Larynx
Magnetic Resonance Imaging
Mammography
Salivary Glands
Skin

Figure

  • Fig. 1 51-year-old woman with adenoid cystic carcinoma in left breast. A, B. Craniocaudal and mediolateral oblique views of mammography show a circumscribed round isodense mass in palpable site of the left breast upper center without suspicious calcification. C, D. Transverse sonography shows about 2.0 cm sized indistinct oval hypoechoic mass in left breast upper center without increased vascularity and posterior features. LCC = left craniocaudal, LMLO = left mediolateral oblique

  • Fig. 2 MRI findings of adenoid cystic carcinoma in the breast. A. The axial T1-weighted pre-contrast image shows a low signal intensity mass in the left breast. B. The sagittal T2-weighted image shows a smooth round moderately high signal intensity mass in left breast. C. The axial dynamic-enhanced T1-weighted image of the first post-contrast acquisition shows about 2.3 cm sized rapid enhancing mass in the left breast. D. The subtraction image shows persistent enhancement pattern (type I).

  • Fig. 3 On the axial positron emission tomography/computed tomography fusion image and MIP, the mass shows hypermetabolism (maximum standardized uptake value: 3.4) without metastasis (arrow).

  • Fig. 4 Microscopic findings of pathologically confirmed adenoid cystic carcinoma. A. The mass is mostly consisted of small basaloid cells. The tumor cells surround pseudoglandular spaces forming variable sized cribriform nests (arrow) (H&E stain, × 100). B, C. The pseudoglandular spaces are filled with PAS + mucinous materials (arrow) and surrounded by basement membrane materials highlightened by immunohistochemical staining for laminin (B. PAS stain, × 200, C. Laminin, × 100). D. The tumor cells are focally positive for c-kit (c-kit, × 100). H&E = hematoxylin and eosin, PAS = Periodic Acid-Schiff


Reference

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