J Breast Cancer.  2016 Sep;19(3):330-333. 10.4048/jbc.2016.19.3.330.

Radiologic Findings of Primary Mucinous Cystadenocarcinoma of the Breast: A Report of Two Cases and a Literature Review

• Seong M
• Ko EY
• Han BK
• Cho SY
• Cho EY
• Lee SK
• Lee JE

• KMID: 2413959
• DOI: http://doi.org/10.4048/jbc.2016.19.3.330

Abstract

Primary mucinous cystadenocarcinoma (MCA) of the breast is a rare but pathologically distinct breast tumor. There have been some case reports on primary MCA of the breast; however, they have all focused on pathologic findings. Here, we report the radiologic findings of two cases of MCA along with a review of the literature. Breast MCA shows a circumscribed mass with some calcifications on mammography, an intracystic solid mass without increased vascularity or a vascular stalk on ultrasound, and a heterogeneously enhancing mass within a rim-enhancing cyst with intermediate signal intensity on T2-weighted magnetic resonance imaging. These radiologic findings and the presence of mucin in the percutaneous biopsy specimen should suggest the possibility of MCA in the differential diagnosis of a breast tumor.

Keyword

Breast; Magnetic resonance imaging; Mucinous cystadenocarcinoma; Ultrasound

MeSH Terms

Biopsy
Breast Neoplasms
Breast*
Cystadenocarcinoma, Mucinous*
Diagnosis, Differential
Magnetic Resonance Imaging
Mammography
Mucins*
Ultrasonography
Mucins

Figure

• 

  Figure 1 A 59-year-old female with mucinous cystadenocarcinoma (MCA) in the left breast. (A) Mediolateral oblique view of mammography shows a 2.8 cm sized lobular-shaped circumscribed hyperdense mass containing round or punctate microcalcifications (arrows) in the upper outer quadrant of the left breast. (B) On ultrasound, the MCA appears as a circumscribed complex cystic and solid mass. The solid portion of the mass (arrows) shows an irregular shape and isoechogenicity, with multiple echogenic dots corresponding to the microcalcifications seen on mammography. On magnetic resonance imaging, the solid portion shows low signal intensity (SI) on T1 weighted imaging (WI) (C) and intermediate SI on T2-WI (arrows) (D). The cystic portion shows rim-enhancement and the solid portion (arrow) shows nodular enhancement on dynamic contrast-enhanced image with persistent enhancement kinetics (E). (F) The tumor is composed of multiple cysts distended by mucinous secretion and the cysts are lined with tall columnar cells with intracytoplasmic Most nuclei are basally located and somewhat bland, however some nuclei show more atypia. Note the psammomatous calcification (arrow) in the papillary core (H&E stain, ×400).

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  Figure 2 A 50-year-old female with mucinous cystadenocarcinoma in the left breast. (A) Mediolateral oblique view of mammography shows a 2.8 cm sized lobular-shaped isodense mass with obscured margin and a few faint microcalcifications in the left mid outer breast (arrows). (B) A multilobulated complex cystic and solid mass is seen on ultrasound (US). The solid portion of the mass (arrows) is hypoechoic and the margin is partially indistinct. (C) Vascularity is not increased and a vascular stalk is not detected on Doppler US. On magnetic resonance imaging, a cystic and solid mass is shown. The solid portion (arrow) has an irregular shape and the margin shows hypointensity on T1 weighted imaging (WI) (D), intermediate signal intensity on T2-WI (E), and heterogeneous enhancement with persistent enhancement kinetics (F). (G) Core biopsy shows multilocular cystic lesion containing extracellular mucin. The cyst wall is lined with tall columnar mucinous epithelium (arrows) (H&E stain, ×100). (H) Mucinous epithelium shows marked atypia and pleomorphism. There are frequent mitotic figures (H&E stain, ×400).

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