To report a case of malignant adenomyoepithelioma (MAME) in the breast and to discuss the diagnostic challenges related to histologic-subtype discordance.
Approach:
Case Presentation: An 84-year-old woman presented with a palpable left breast nodule. Diagnostic imaging and core needle biopsy suggested invasive carcinoma, but final pathology confirmed MAME.
Literature Review: A structured literature review was conducted to analyze cases of MAME, focusing on discrepancies between preoperative diagnoses and final pathology.
Key Findings:
Malignant adenomyoepithelioma is a rare biphasic neoplasm with potential for local recurrence and distant metastasis.
Core needle biopsy may undersample the malignant features, leading to diagnostic discordance.
Final pathology confirmed grade 3 malignant MAME with negative surgical margins and uninvolved sentinel lymph nodes.
Interpretation:
Histologic-subtype discordance is a significant diagnostic challenge in MAME, as evidenced by the discrepancy between preoperative and final diagnoses.
Limitations:
Limited population-based data on malignant adenomyoepithelioma.
The rarity of the condition restricts the generalizability of findings.
Conclusion:
Negative-margin resection is crucial for management, and comprehensive immunohistochemical evaluation is necessary due to potential diagnostic challenges.
