J Korean Soc Radiol.  2020 Jan;81(1):207-212. 10.3348/jksr.2020.81.1.207.

Rapid Local Recurrence of Breast Myoepithelial Carcinoma Arising in Adenomyoepithelioma: A Case Report

• Ha MI
• Seo BK
• Choi JW

• KMID: 2469195
• DOI: http://doi.org/10.3348/jksr.2020.81.1.207

Abstract

Adenomyoepithelioma (AME) is a rare breast neoplasm composed of both epithelial and myoepithelial cells with biphasic proliferation. Although most AMEs are benign, malignant transformation of either or both cellular components may occur. This report describes an unusual rapid local tumor recurrence a month after excision of the myoepithelial carcinoma arising in an AME. Ultrasound and MRI showed small recurrent masses in the superficial part of a hematoma. This report suggests the benefit of immediate postoperative breast imaging in patients with malignant AME with potential for local recurrence, such as those with narrow resection margins or high mitotic activity.

MeSH Terms

Adenomyoepithelioma*
Breast Neoplasms
Breast*
Hematoma
Humans
Magnetic Resonance Imaging
Neoplasm Recurrence, Local
Recurrence*
Ultrasonography

Figure

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  Fig. 1 Rapid local recurrence of breast myoepithelial carcinoma arising in adenomyoepithelioma in a 50 year old woman. A. A right craniocaudal mammogram shows a 4 cm-long, irregular, hyperdense mass (arrow) with indistinct margins in the right breast. B. B-mode breast ultrasound imaging (left panel) demonstrates an indistinct, irregular, complex cystic and solid echoic mass (arrows). Doppler ultrasound imaging (right panel) shows linear and branching blood flow in the mass (arrowheads). C. Histology (left panel) shows a majority of myoepithelial carcinoma with a minority of biphasic pattern of epithelial and myoepithelial cell proliferation (arrowheads). The myoepithelial carcinoma (middle panel) shows plasmacytoid myoepithelial cells with moderate nuclear atypia and high mitotic activity (28 per 10 high-power fields). Immunohistochemical staging (right panel) shows that tumor cells are positive for the myoepithelial marker p63. H&E = hematoxylin and eosin stain D. Axial fat-saturated T1-weighted dynamic imaging shows small homogeneous or rim-enhancing masses (arrowheads) in the superficial part of the postoperative hematoma (arrows). E. B-mode breast ultrasound imaging (upper panel) reveals circumscribed or indistinct round hypoechoic masses (arrowheads) in the superficial part of the hematoma (curved arrows). Doppler ultrasound imaging (lower panel) demonstrates peripheral, linear, and branching blood flow (arrows). F. Gross specimen shows the whitish recurred mass (arrowhead) located in the superficial part of the hematoma (arrows).

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