J Korean Surg Soc.  2011 Sep;81(3):211-215. 10.4174/jkss.2011.81.3.211.

Myoepithelial carcinoma with contralateral invasive micropapillary carcinoma of the breast

• Kwon SY
• Bae YK
• Cho J
• Kang SH

• KMID: 2212199
• DOI: http://doi.org/10.4174/jkss.2011.81.3.211

Abstract

Adenomyoepithelioma (AME) is a rare benign tumor composed of myoepithelial cells (MECs) which are located beneath the epithelial cells of exocrine glands, especially in breast and salivary glands. These tumor cells show biphasic proliferation of epithelial and MECs. Malignant AME is characterized by distant metastasis, local recurrence, cytologic atypia, high mitotic activity and infiltrating tumor margins. A 51-year-old woman presented with an 8 months growth in the left breast. She underwent core-needle biopsy and consecutively mammotome assisted biopsy at a local clinic. After resection, she complained about re-growing remnant lesion and a newly developed solid mass in the right breast. Finally, the remnant mass in the left breast was diagnosed with myoepithelial carcinoma. Concurrently, contralateral breast mass was diagnosed with invasive micropapillary carcinoma. Herein we report an unusual case of synchronous myoepithelial carcinoma and invasive micropapillary carcinoma of the breast with a review of literatures.

Keyword

Breast; Adenomyoepithelioma; Myoepithelial carcinoma; Micropapillary carcinoma

MeSH Terms

Adenomyoepithelioma
Amphotericin B
Biopsy
Breast
Epithelial Cells
Exocrine Glands
Female
Humans
Middle Aged
Neoplasm Metastasis
Recurrence
Salivary Glands
Amphotericin B

Figure

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  Fig. 1 (A) Right mammogram showed a spiculated and heterogenous nodule without a focal lesion or microcalcification. (B) Left mammogram demonstrated a lobulated and iso-density nodule. (C) Preoperative ultrasonogram of the left breast revealed a 1.0 cm sized inhomogeneous, irregular marginated and hypoechoic mass.

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  Fig. 2 Microscopic findings of the left breast mass (A-C) and the right breast mass (D). (A) The central lesion of the left breast mass demonstrated adenomyoepithelioma with atypical spindle cells at the left lower corner (H&E, ×100). (B) The atypical spindle tumor cells showed round to spindle, hyperchromatic and pleomorphic nuclei with relatively abundant eosinophilic cytoplasm (H&E, ×400). (C) Atypical mitotic figure (arrow) was found (H&E, ×400). (D) Invasive micropapillary carcinoma was identified in the right breast (H&E, ×200).

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  Fig. 3 Myoepithelial carcinoma revealed diffuse strong reactivity for smooth muscle actin (A, immunohistochemical stain, ×200), calponin (B, immunohistochemical stain, ×200), p63 (C, immunohistochemical stain, ×200) and pan-cytokeratin (D, immunohistochemical stain, ×200).

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