Adenomyoepithelioma is a proliferative disorder of both epithelial and myoepithelial cells. This lesion may be found in salivary glands, skin appendages and, very rarely, in the mammary gland. Adenomyoepithelioma was first described in 1970 and very few cases have so far been reviewed in the literature. This paper reports the clinical, histological and immunohistochemical characteristics of an adenomyoepithelioma in a 24 year old woman; to our knowledge this is the first published case in such a young patient. The clinical feature suggested a fibroadenoma. A more complete study of the excised tumor tissue by immunohistochemical and ultrastructural analysis proved that the correct diagnosis was adenomyoepithelioma. Whether adenomyoepithelioma is a benign or a low-grade malignant lesion is still controversial and, therefore, the therapeutic approach is not well defined.
Get full access to this article
View all access options for this article.
References
1.
AhmedA.: The myoepithelium in human breast carcinoma. J. Pathol., 113: 129–135, 1974.
2.
AzzopardiJ.G.: Problems in breast pathology. In: Major Problems in Pathology, Vol. 11, pp. 339–340, W.B. Saunders Company. Ltd, London, Philadelphia, Toronto, 1979.
3.
BarwickK.W., KashgarianM., RosenP.P.: « Clear cell » change within duct and lobular epithelium of the human breast. Pathol. Annu., 17: 319–328, 1982.
4.
BastakisJ.C., KraemerB., SciubbaJ.: The pathology of head and neck tumors: XVII. The mioepithelial cell and its participation in salivary gland neoplasia. Head Neck Surg., 5: 222–223, 1983.
5.
BenischB., PeisonB., NewmanR., SobelH.J., MarquetE.: Solid glycogen-rich clear cell carcinoma of the breast (a light and ultrastructural study). Am. J. Clin. Pathol., 79: 243–245, 1983.
6.
BigottiG., Di GiorgioC.G.: Mioepithelioma of the breast: Histologic, immunologic and electromicroscopic appearance. J. Surg. Oncol., 32: 58–64, 1986.
7.
CameronH.M., HamperlH., WaramboW.: Leiomyosarcoma of the breast originating from myothelium (myoepithelium). J. Pathol., 114: 89–96, 1974.
8.
ClementP.B., AzzopardiJ.G.: Microglandular adenosis of the breast: a lesion simulating tubular carcinoma. Histopathology, 7: 169–180, 1983.
9.
CorioR.L., SciubbaJ.J., BrannonR.B., BastakisJ.G.: Epithelial-myoepithelial carcinoma of intercalated duct origin. A clinicopathologic and ultrastructural assessment of sixteen cases. Oral Surg., 53: 280–287, 1982.
DardickI., van NostrandA.W.P., PhillipsM.J.: Histogenesis of salivary gland pleomorphic adenoma (mixed tumor) with an evaluation of the role of myoepithelial cell. Hum. Pathol., 13: 62–75, 1982.
12.
DardickI., van NostrandA.W.P.: Myoepithelial cells in salivary gland tumors-revisited. Head Neck Surg., 7: 395–408, 1985.
13.
ErlandsonR.A., RosenP.P.: Infiltrating myoepithelioma of the breast. Am J. Surg. Pathol., 6: 785–793, 1982.
14.
EusebiV., BettsC.M., BussolatiG.: Tubular carcinoma: a variant of secretory breast carcinoma. Histopathology, 3: 407–419, 1979.
15.
EusebiV., CasadeiG.P., BussolatiG., AzzopardiJ.G.: Adenomyoepithelioma of the breast with distinctive type of apocrine adenosis. Histopathology, 3: 305–315, 1987.
16.
FinckF.M., SchwinnC.P., KeasbeyL.E.: Clear cell hidradenoma of the breast. Cancer, 22: 125–135, 1968.
17.
FisherE.R., TavaresJ., BulataoI.S., SassR., FisherB.: Glycogen-rich, clear cell breast cancer: with comments concerning other clear cell variants. Hum. Pathol., 16: 1085–1090, 1985.
18.
GoldmanR.L., KleinzH.Z.: Glycogen rich adenoma of the parotid gland. Cancer, 30: 749–754, 1972.
19.
GouldV.E., JaoW., BattiforaH.: Ultrastructural analysis in the differential diagnosis of breast tumors. The significance of myoepithelial cells, basal lamina, intracytoplasmic lumina, secretory granules. Pathol. Res. Pract., 167: 45–70, 1980.
20.
HamperlH.: The myoepithelia (myoepithelial cells): normal state, regressive changes, hyperplasia, tumors. Curr. Topics Pathol., 53: 194–198, 1970.
21.
HertelB.F., ZaloudekC., KempsonR.L.: Breast adenomas. Cancer, 37: 2891–2905, 1976.
22.
HullM.T., PriestJ.B., BroadieT.A., RansburgR.G., McCarthyL.Y.: Glycogen-rich clear cell carcinoma of the breast. Cancer, 48: 2003–2009, 1981.
23.
JabiM., DardickI., CardigosN.: Adenomyoepithelioma of the breast. Arch. Pathol. Lab. Med., 112: 73–76, Jan 1988.
24.
JaoW., VazquezL.T., KehP.C., GouldV.E.: Myoepithelial differentiation and basal lamina deposition in fibroadenoma and adenosis of the breast. J. Pathol., 126: 107–112, 1978.
25.
KahnH.J., BaumalR., MarksA.: Myoepithelial cells in salivary glands tumors: an immunohistochemical study. Arch. Pathol. Lab. Med., 109: 190–195, 1985.
KiaerH., NielsenB., PaulsenS., SorensenI.M., DyreborgU., Blichert-ToftM.: Adenomyoepithelial adenosis and low grade malignant adenomyoepithelioma of the breast. Virchows Arch., 405: 55–67, 1984.
28.
LunaM.A., OrdonezN.G., Mac KayB.: Salivary epithelial-myoepithelial carcinomas of intercalated ducts: a clinical, electron microscopic and immunocytochemical study. Oral Surg., 59: 482–490, 1985.
29.
MakekM., Von HochstetterA.R.: Pleomorphic adenoma of the human breast. J. Surg. Oncol., 14: 281–286, 1980.
30.
McClureJ., SmithP.S., JamiesonG.C.: « Mixed » salivary type adenoma of the human female breast. Arch. Pathol. Lab. Med., 106: 615–619, 1982.
31.
MerinoM.J., LivolsiV.A.: Signet ring carcinoma of the female breast: a clinicopathologic analysis of 14 cases. Cancer, 48: 1830–1837, 1981.
32.
MuradT.M., Von HaamE.: Ultrastructure of myoepithelial cells in human mammary glands tumors. Cancer, 21: 1137–1149, 1968.
33.
ObermanH.A.: Secretory carcinoma of the breast in adults. Am J. Surg. Pathol., 4: 465–470, 1980.
34.
OhtaniH., SasanoN.: Myofibroblasts and myoepithelial cells in human breast carcinoma: an ultrastructural study. Virchows Arch. Pathol. Anat. Histol., 385: 247–261, 1980.
RodeL., NeslandJ.M., JohannessenJ.V.: A spindle cell breast lesion in a 54 years old woman. Ultrastruct. Pathol., 10: 421–425, 1986.
37.
RosenP.P.: Microglandular adenosis: a benign lesion simulating invasive mammary carcinoma. Am. J. Surg. Pathol., 7: 137–144, 1983.
38.
RosenP.P.: Adenomyoepithelioma of the breast. Hum. Pathol., vol. XVIII, 12: 1232–1237, 1987.
39.
RosenblumM.K., PurrazzellaR., RosenP.P.: Is microglandular adenosis a precancerous disease? A study of carcinoma arising therein. Am. J. Surg. Pathol., 10: 237–245, 1986.
40.
SakselaE., TarkkanenJ., WartiovaaraJ.: Parotid clear cell adenoma of possible myoepithelial origin. Cancer, 30: 742–748, 1972.
41.
SchurchW., PotvinC., SeemayerT.A.: Malignant myoepithelioma (myoepithelial carcinoma) of the breast: an ultrastructural and immunocytochemical study. Ultrastruct. Pathol., 8: 1–11, 1985.
42.
SeemayerT.A., SchurchW., LagacèR., TremblayG.: Myofibroblasts in the stroma of invasive and metastatic carcinoma. A possible host response to neoplasia. Am. J. Surg. Pathol., 3: 525–533, 1979.
43.
ShethM.T., HathwayD., PetrelliM.: Pleomorphic adenoma (« mixed » tumor) of human female breast mimicking carcinoma clinico-radiologically. Cancer, 41: 659–665, 1978.
44.
TavassoliF.A., NorrisH.J.: Secretory carcinoma of the breast. Cancer, 45: 2404–2413, 1980.
45.
TavassoliF.A., NorrisH.J.: Microglandular adenosis of the breast. A clinicopathologic study of 11 cases with ultrastructural observations. Am. J. Surg. Pathol., 7: 731–737, 1983.
46.
TamuraS., EnjojiM., ToyoshimaS., TerasakaR.: Adenomyoepithelioma of the breast. A case report with an immunohistochemical study. Acta Pathol. Jpn., 38(5): 659–665, 1988.
47.
ThackrayA.C., LucasR.B.: Clear cell adenoma, in tumors of the major salivary glands. Armed Forces Institute of Pathology, series 7, fascicle 10, pp. 62–63, 1974.
48.
ThornerP.S., KahnH.J., BaumalR., LeeK., MoffattW.: Malignant myoepithelioma of the breast: an immunohistochemical study by light and electron microscopy. Cancer, 57: 745–750, 1986.
TremblayG.: Stromal aspect of breast carcinoma. Exp. Mol. Pathol., 31: 248–260, 1979.
51.
Van BogaertL.J., MaldagueP.: Histologic variants of lipid-secreting carcinoma of the breast. Virchows Arch. Pathol. Anat., 375: 345–353, 1977.
52.
Van der WaltJ.D., RohlovaB.: Pleomorphic adenoma of the human breast: report of a benign tumor closely mimicking a carcinoma clinically. Clin. Oncol., 8: 361–365, 1982.
53.
YoungR.H., ClementP.B.: Adenomyoepithelioma of the breast. A report of three cases and review of the literature. Am. J. Clin. Pathol., 9: 308–314, 1988.
54.
ZarboR.J., ObermanH.A.: Cellular adenomyoepithelioma of the breast. Am. J. Surg. Pathol., 7: 863–870, 1983.
