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(25): 7579-7587 [PMID: 34616829 DOI: 10.12998/wjcc.v9.i25.7579]
Corresponding Author of This Article
Jin Kyung An, MD, PhD, Associate Professor, Department of Radiology, Nowon Eulji Medical Center, Eulji University School of Medicine, 68 Hangeulbiseok-ro, Nowon-gu, Seoul 01830, South Korea. jkan0831@eulji.ac.kr
Research Domain of This Article
Radiology, Nuclear Medicine & Medical Imaging
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Sep 6, 2021; 9(25): 7579-7587 Published online Sep 6, 2021. doi: 10.12998/wjcc.v9.i25.7579
Breast adenoid cystic carcinoma arising in microglandular adenosis: A case report and review of literature
Jin Kyung An, Jeong Joo Woo, Eun Kyung Kim, Hee Yong Kwak
Jin Kyung An, 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
Author contributions: An JK contributed to conceptualization and supervision; An JK and Kim EK do the original draft preparation; An JK, Kim EK and Kwak HY do the data curation; An JK, Woo JJ and Kim EK do the formal analysis; all author validate, review and edit the manuscript.
Informed consent statement: This study was reviewed and approved as a retrospective case report by the Institutional Review Board of Eulji Medical Center, Seoul, Korea (EMCIRB 2021-01-003), with informed consent from the patient waived.
Conflict-of-interest statement: The authors have no potential conflicts of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jin Kyung An, MD, PhD, Associate Professor, Department of Radiology, Nowon Eulji Medical Center, Eulji University School of Medicine, 68 Hangeulbiseok-ro, Nowon-gu, Seoul 01830, South Korea. jkan0831@eulji.ac.kr
Received: March 31, 2021 Peer-review started: March 31, 2021 First decision: June 7, 2021 Revised: June 7, 2021 Accepted: July 29, 2021 Article in press: July 29, 2021 Published online: September 6, 2021
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.
Core Tip: Many pathological or clinical studies have been reported for adenoid cystic carcinoma (AdCC) arising in microglandular adenosis (MGA), but few reports have been reported of radiological findings. In our case, it was characterized by iso- or slight hypo-density in the mammogram and slightly higher echo than that of fat in the ultrasound examination with higher T2 signal intensity and a persistent enhancing pattern in breast magnetic resonance imaging. Although AdCC shows a favorable prognosis and MGA has long been considered a benign entity, there is a risk of MGA becoming malignant and a complete resection should be performed.
