J Breast Cancer.  2015 Dec;18(4):400-403. 10.4048/jbc.2015.18.4.400.

Malignant Adenomyoepithelioma of the Breast and Responsiveness to Eribulin

• Lee S
• Oh SY
• Kim SH
• Lee JH
• Kim DC
• Cho SH
• Lee M
• Kim HJ

• KMID: 2176292
• DOI: http://doi.org/10.4048/jbc.2015.18.4.400

Abstract

Adenomyoepithelioma (AME) of the breast is an uncommon tumor characterized by its dual differentiation into luminal cells and myoepithelial cells. In most cases these tumors have a benign clinical course, but distant metastases have been reported. We present the case of a 51-year-old woman diagnosed with malignant AME. The patient underwent a right modified radical mastectomy, and pathological examination confirmed the diagnosis of malignant AME. Ten months after the operation, multiple hepatic, pleural, and abdominal wall metastases were detected. A number of palliative chemotherapeutic agents were tried, including anthracycline and taxanes. However, the disease continued to progress, and superior vena cava syndrome developed as a result of direct tumor invasion. The patient received salvage eribulin monotherapy. After two cycles of this treatment, her clinical symptoms were ameliorated, and a computed tomography scan showed a partial response. Eribulin chemotherapy was thus effective in treating malignant AME in this case.

Keyword

Breast; Eribulin; Malignant adenomyoepithelioma; Neplasm metastasis

MeSH Terms

Abdominal Wall
Adenomyoepithelioma*
Breast*
Diagnosis
Drug Therapy
Female
Humans
Mastectomy, Modified Radical
Middle Aged
Neoplasm Metastasis
Phenobarbital
Superior Vena Cava Syndrome
Taxoids
Phenobarbital
Taxoids

Figure

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  Figure 1 Malignant adenomyoepithelioma of the breast. (A) Biphasic proliferation of both inner eptithelial and outer myoepithelial cells was shown (H&E stain, ×200). (B) Atypia was obvious in both myoepithelial and ductal epithelial cells with moderate degree of nuclear pleomorphism, prominent nucleoli, high nuclear cytoplasmic ratio and increased mitotic figures (H&E stain, ×400). (C) The ductal cells were positive for CK5/6 (immunoperoxidase, ×40). (D) The myoepithelial cells were positive for p63 (immunoperoxidase, ×40). (E) The tumor showed lymphovascular invasion (H&E stain, ×100).

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  Figure 2 Radiologic findings for chest computed tomography (CT). CT scan showed marked enlarged recurred mass lesion in right mediastinal pleural areas, which invaded to right pulmonary trunk and superior vena cava.

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  Figure 3 Histological features of metastatic lesion. The abdominal mass showed similar histological findings as in malignant adenomyoepithelioma of the breast (H&E stain, ×20).

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  Figure 4 Chest computed tomography (CT) after eribulin treatment. After two cycles of eribulin treatment, the follow-up CT scan showed decreased extent of recurred mass lesion in right mediastinal pleural areas.

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