|
1
|
Hmidi A, Houcine Y, Naija L, Mansour HB, Driss M. Solid-basaloid variant of adenoid cystic carcinoma of the breast unresponsive to neoadjuvant chemotherapy: Case report. Int J Surg Case Rep 2023; 111:108858. [PMID: 37757737 PMCID: PMC10539882 DOI: 10.1016/j.ijscr.2023.108858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 09/17/2023] [Accepted: 09/18/2023] [Indexed: 09/29/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE Adenoid cystic carcinoma (ACC) is a rare triple-negative breast cancer, accounting for only 0.1 % of all primary breast carcinomas. At variance with the classic variant, the solid-basaloid variant of ACC (SB-ACC) is clinically more aggressive and has different molecular features. There is, currently, no consensus regarding the treatment of SB-ACC of the breast, especially the use of neoadjuvant chemotherapy. CASE PRESENTATION Here, we present a rare case of SB-ACC in an elderly female patient, with no history of breast carcinoma, who presented with a 4.5 cm central round mass invading the nipple. Given the locally advanced triple negative breast cancer and the invasion of the nipple-areolar complex, the patient has received neoadjuvant chemotherapy followed by surgical treatment. On histopathological examination, the diagnosis of SB-ACC, non-responsive to neoadjuvant chemotherapy, with absence of rearrangement of the MYB gene was retained. The patient received adjuvant radiation therapy and was ambulatory followed without recurrence at the 12-month follow-up. DISCUSSION/CONCLUSION This case provided direct evidence that SB-ACC of the breast wasn't responsive to neoadjuvant chemotherapy but cannot allow for definitive conclusions on chemotherapy recommendations. For this reason, more data must be published to investigate the real value of neoadjuvant chemotherapy in SB-ACC.
Collapse
Affiliation(s)
- Amira Hmidi
- Pathology Department, Salah Azaiez Institute, Tunis, Tunisia.
| | - Yoldez Houcine
- Pathology Department, Salah Azaiez Institute, Tunis, Tunisia
| | - Lamia Naija
- Surgical Oncology Department, Salah Azaiez Institute, Tunis, Tunisia
| | | | - Maha Driss
- Pathology Department, Salah Azaiez Institute, Tunis, Tunisia
| |
Collapse
|
|
2
|
Liu Z, Wang M, Wang Y, Shen X, Li C. Diagnosis of adenoid cystic carcinoma in the breast: a case report and literature review. Arch Med Sci 2022; 18:279-283. [PMID: 35154549 PMCID: PMC8826839 DOI: 10.5114/aoms/144321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 11/29/2021] [Indexed: 11/17/2022] Open
Affiliation(s)
- Zihui Liu
- Department of Pathology, The Affiliated Hospital of Chengde Medical College, Chengde, Hebei Province, China
| | - Minghui Wang
- Department of Breast Surgery, The Affiliated Hospital of Chengde Medical College, Chengde, Hebei Province, China
| | - Yan Wang
- Department of Pathology, The Affiliated Hospital of Chengde Medical College, Chengde, Hebei Province, China
| | - Xingbin Shen
- Department of Pathology, The Affiliated Hospital of Chengde Medical College, Chengde, Hebei Province, China
| | - Chunhui Li
- Department of Pathology, The Affiliated Hospital of Chengde Medical College, Chengde, Hebei Province, China
| |
Collapse
|
|
3
|
Accardo G, Capobianco AM, Torre GL, Thodas A, Marino G, Sisti LG, Vita G. Adenoid cystic carcinoma of the breast and intraoperative electron radiotherapy: single case report and review of literature. Future Oncol 2021; 18:871-881. [PMID: 34904444 DOI: 10.2217/fon-2021-0860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Adenoid cystic carcinoma (ACC) of the breast is a very rare neoplasm. It presents a triple-negative phenotype in most cases, but its prognosis is generally considered to be better than other breast cancers with the same immunohistochemical pattern. Due to its controversial features, no data are available in the literature regarding a consensus approach for ACC treatment, especially for subtypes with worse prognosis like solid basaloid ACC. We present for the first time a rare case of ACC with multifocal presentation treated with breast-conservative surgery and intraoperative electron radiotherapy, thus supporting this treatment of ACC in selected patients like young women affected by the solid basaloid variant who commonly present a worse prognosis. In this case, no local or systemic recurrence was detected after 30 months of follow-up.
Collapse
Affiliation(s)
- Giuseppe Accardo
- Department of Breast Surgery, Centro di riferimento oncologico della Basilicata (IRCCS-CROB), 85028, Rionero in Vulture (PZ), Italy
| | - Alba Ml Capobianco
- Head of Multidisciplinary Oncology Unit, Centro di riferimento oncologico della Basilicata (IRCCS-CROB), 85028, Rionero in Vulture (PZ), Italy
| | - Giuseppe La Torre
- Department of Breast Surgery, Centro di riferimento oncologico della Basilicata (IRCCS-CROB), 85028, Rionero in Vulture (PZ), Italy
| | - Alexios Thodas
- Department of Breast Surgery, Centro di riferimento oncologico della Basilicata (IRCCS-CROB), 85028, Rionero in Vulture (PZ), Italy
| | - Graziella Marino
- Department of Breast Surgery, Centro di riferimento oncologico della Basilicata (IRCCS-CROB), 85028, Rionero in Vulture (PZ), Italy
| | - Leuconoe Grazia Sisti
- Center for Global Health Research and studies and Department of Public Health, Section of Hygiene, Catholic University of Sacred Heart, 00168, Rome, Italy
| | - Giulia Vita
- Department of Pathology, Centro di riferimento oncologico della Basilicata (IRCCS-CROB), 85028, Rionero in Vulture (PZ), Italy
| |
Collapse
|
|
4
|
An JK, Woo JJ, Kim EK, Kwak HY. Breast adenoid cystic carcinoma arising in microglandular adenosis: A case report and review of literature. World J Clin Cases 2021; 9:7579-7587. [PMID: 34616829 PMCID: PMC8464440 DOI: 10.12998/wjcc.v9.i25.7579] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 06/13/2021] [Accepted: 07/29/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Breast adenoid cystic carcinoma (AdCC) is a rare invasive carcinoma composed of epithelial and myoepithelial cells. Microglandular adenosis (MGA) is a rare benign proliferative lesion consisting of small, uniform, and round glands formed by a single layer of epithelial cells and basement membrane without a myoepithelial cell layer. MGA may progress to atypical MGA and carcinoma arising in MGA. Among various invasive carcinomas from MGA, AdCC has been rarely reported. Here, we report a case of AdCC arising in MGA.
CASE SUMMARY A 59-year-old woman was diagnosed with a newly developed density on a routine mammogram. The density was similar to or slightly lower than that of the breast parenchyma. Sonography showed an irregular mass with a slightly higher echo than that of fat. Magnetic resonance imaging showed an irregular mass with a similar T1 signal intensity and a slightly higher T2 signal intensity compared to muscles or the breast parenchyma. The lesion showed heterogeneous internal enhancement with an initially slow and delayed persistent enhancing pattern. Microscopically, the tumor was composed of invasive AdCC, in situ AdCC, and MGA. AdCC is composed of basaloid and ductal epithelial cells forming cribriform or solid sheets, or haphazardly scattered small cribriform or tubular glands. MGA showed small glands with a single epithelial lining and retained lumen. S-100 staining was strongly positive in MGA area. The patient underwent breast-conserving surgery with sentinel lymph node biopsy.
CONCLUSION Breast AdCC arising in MGA showed unique imaging findings that was different from usual invasive cancer.
Collapse
Affiliation(s)
- Jin Kyung An
- Department of Radiology, Nowon Eulji Medical Center, Eulji University School of Medicine, Seoul 01830, South Korea
| | - Jeong Joo Woo
- Department of Radiology, Nowon Eulji Medical Center, Eulji University School of Medicine, Seoul 01830, South Korea
| | - Eun Kyung Kim
- Department of Pathology, Nowon Eulji Medical Center, Eulji University School of Medicine, Seoul 01830, South Korea
| | - Hee Yong Kwak
- Department of Surgery, Nowon Eulji Medical Center, Eulji University School of Medicine, Seoul 01830, South Korea
| |
Collapse
|
|
5
|
Pang W, Wang Z, Jin X, Zhang Q. Adenoid cystic carcinoma of the breast in a male: A case report. Medicine (Baltimore) 2019; 98:e16760. [PMID: 31393393 PMCID: PMC6708915 DOI: 10.1097/md.0000000000016760] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Revised: 06/06/2019] [Accepted: 07/16/2019] [Indexed: 01/27/2023] Open
Abstract
RATIONALE Adenoid cystic carcinoma (ACC) of the breast is an infrequent neoplasm, and the occurrence in males is rare. Therefore, diagnostic and therapeutic challenges are inevitable. PATIENT CONCERNS Herein, we present a case of a 44-year-old man with a tumor on his right breast that he had known about for 6 years. DIAGNOSES The patient underwent a lumpectomy, and the histological examination confirmed a diagnosis of ACC. INTERVENTIONS Modified radical mastectomy was subsequently conducted in the patient. No positive lymph nodes were observed in the postoperative pathological examination. Following the surgery, the patient received adjuvant chemotherapy. OUTCOMES The patient remained recurrence-free at 26 months. LESSONS Compared to female breast ACC, male breast ACC may behave differently biologically and have a different prognosis. Our case will provide more diagnostic and treatment experience to deal with this disease.
Collapse
|
|
6
|
Adenoid cystic carcinoma of the breast, high grade with basal phenotype, literature review. INTERNATIONAL JOURNAL OF SURGERY OPEN 2018. [DOI: 10.1016/j.ijso.2017.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
|
7
|
Spiliopoulos D, Mitsopoulos G, Kaptanis S, Halkias C. Axillary lymph node metastases in adenoid cystic carcinoma of the breast. A rare finding. G Chir 2016; 36:209-13. [PMID: 26712257 DOI: 10.11138/gchir/2015.36.5.209] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Adenoid cystic carcinoma (ACC) of the breast is a rare malignant salivary-type neoplasm that has a good prognosis and represents less than 1% of all breast cancers. It is a triple negative carcinoma that presents as a painful mass. The mean age at the time of diagnosis is 50-60 years old. The solid variant of this type of tumour with basaloid features and presence of nodal metastases is very rare and considered to have a more aggressive clinical course. We present a case with presence of axillary lymph node metastases that was successfully treated with no evidence of recurrence one year after the diagnosis and review the literature.
Collapse
|
|
8
|
Miller T, Albarracin C, Carkaci S, Whitman GJ, Adrada BE. Rare Malignant Tumors of the Breast. J Clin Imaging Sci 2015; 5:58. [PMID: 26664775 PMCID: PMC4647127 DOI: 10.4103/2156-7514.168711] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2015] [Accepted: 10/06/2015] [Indexed: 11/04/2022] Open
Abstract
While the more common forms of breast cancer are well understood and recognized, there are many important rare malignancies that are less appreciated. Many of these cancers have imaging findings that, when understood, help to formulate a more educated differential diagnosis. In this article, the clinical features, imaging, and pathologic findings of rare breast malignancies will be discussed.
Collapse
Affiliation(s)
- Trevor Miller
- Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York City, New York, USA
| | | | - Selin Carkaci
- Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Gary J Whitman
- Department of Radiology, MD Anderson Cancer Center, Houston, Texas, USA
| | - Beatriz E Adrada
- Department of Radiology, MD Anderson Cancer Center, Houston, Texas, USA
| |
Collapse
|
|
9
|
Ilkay TM, Gozde K, Ozgur S, Dilaver D. Diagnosis of adenoid cystic carcinoma of the breast using fine-needle aspiration cytology: A case report and review of the literature. Diagn Cytopathol 2015; 43:722-6. [PMID: 26183224 DOI: 10.1002/dc.23272] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2014] [Revised: 12/27/2014] [Accepted: 03/20/2015] [Indexed: 01/25/2023]
Abstract
Adenoid cystic carcinoma (ACC) of the breast is a rare variant of breast malignancy and is associated with an excellent prognosis. ACC accounts for 0.1% of all breast carcinomas. It has favorable biological characteristics and an excellent prognosis. A 77-year-old woman presented with a lump in the right breast. Ultrasonography and mammography showed a 12-mm, well-defined, lobulated mass in the retroareolar region of the right breast. The lump was diagnosed as ACC on the basis of immunohistochemical staining results for c-kit (CD117), muscle-specific actin, p63, estrogen receptor, and progesterone receptor using a fine-needle aspiration cytology (FNAC) specimen. This diagnosis was subsequently confirmed by excision biopsy. To the best of our knowledge, this is the first case of ACC of the breast to date to be diagnosed on the basis of immunohistochemical staining of an FNAC cell block material. From our experience, we recommend the usage of cell block material for immunohistochemical studies to accurately diagnose ACC of the breast.
Collapse
Affiliation(s)
- Tosun M Ilkay
- Department of Pathology, Umraniye Education and Research Hospital, Istanbul, Turkey
| | - Kir Gozde
- Department of Pathology, Umraniye Education and Research Hospital, Istanbul, Turkey
| | - Sarica Ozgur
- Department of Radiology, Umraniye Education and Research Hospital, Istanbul, Turkey
| | - Demirel Dilaver
- Department of Pathology, GATA Haydarpasa Education Hospital, Istanbul, Turkey
| |
Collapse
|
|
10
|
Canyilmaz E, Uslu GH, Memış Y, Bahat Z, Yildiz K, Yoney A. Adenoid cystic carcinoma of the breast: A case report and literature review. Oncol Lett 2014; 7:1599-1601. [PMID: 24765184 PMCID: PMC3997715 DOI: 10.3892/ol.2014.1945] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2013] [Accepted: 02/04/2014] [Indexed: 01/28/2023] Open
Abstract
Adenoid cystic carcinoma (ACC) is a rare malignant tumor of the breast that occurs in <0.1% of all patients diagnosed with breast cancer. The mean patient age at the time of diagnosis is 50–60 years. Typically, the tumor presents as a subareolar mass or as pain in the breast. While the radiological appearances of ACC are generally non-specific, the diagnosis can be made on fine-needle aspiration cytology. In the present study, a 58-year-old female patient was admitted to the Department of Radiation Oncology (Karadeniz Technical University, Faculty of Medicine, Trabzon, Turkey) with complaints of pain in the upper outer quadrant of the right breast. An excision biopsy of a lump in the upper outer quadrant revealed ACC, and perineural invasion was present. Subsequently, the patient underwent breast conservation surgery and sentinel lymph node dissection. Pathology from the second surgery depicted ACC in the form of microscopic foci around the initial surgical cavity, with two reactive sentinel lymph nodes and the closest negative margin at 2 mm. The patient was treated with radiotherapy following the surgery. No recurrence and metastasis were found after 20 months of follow-up. In conclusion, mammary ACC is a rare malignant neoplasm of the breast. Although surgery is the main treatment, the optimal adjuvant treatment of ACC of the breast has not yet been determined due to its low incidence.
Collapse
Affiliation(s)
- Emine Canyilmaz
- Department of Radiation Oncology, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
| | - Gonca Hanedan Uslu
- Department of Radiation Oncology, Kanuni Research and Education Hospital, Trabzon, Turkey
| | - Yahyahan Memış
- Department of Radiation Oncology, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
| | - Zümrüt Bahat
- Department of Radiation Oncology, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
| | - Kadriye Yildiz
- Department of Pathology, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
| | - Adnan Yoney
- Department of Radiation Oncology, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
| |
Collapse
|
|
11
|
Acevedo C, Amaya C, López-Guerra JL. Rare breast tumors: Review of the literature. Rep Pract Oncol Radiother 2013; 19:267-74. [PMID: 25061520 DOI: 10.1016/j.rpor.2013.08.006] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2013] [Revised: 07/31/2013] [Accepted: 08/22/2013] [Indexed: 12/31/2022] Open
Abstract
Breast cancer tumors have different morphological phenotypes and specific histopathological types with particular prognostic and clinical characteristics. The treatment of rare malignant lesions is frequently controversial due to the absence of trials to determine the optimal managements. This review describes the spectrum of rare breast tumors indicating the clinical, epidemiological and treatment characteristics.
Collapse
Affiliation(s)
- Catalina Acevedo
- Department of Radiation Oncology, Fundación Valle del Lili, Cali, Colombia
| | - Claudia Amaya
- Department of Radiation Oncology, Fundación Valle del Lili, Cali, Colombia
| | | |
Collapse
|