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Ductal carcinoma in situ arising in tubular adenoma of the breast.

Saimura M, Anan K, Mitsuyama S, Ono M, Toyoshima S - Breast Cancer (2012)

Bottom Line: During the regular follow-up, the microcalcification in the mass increased.She was therefore referred to our hospital for further examination.US and MMG showed a well-demarcated mass with a focal microcalcified area.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Kitakyushu Municipal Medical Center, 2-1-1 Bashaku, Kokurakita-ku, Kitakyushu, Fukuoka, 802-0077, Japan, msaimura@med.kyushu-u.ac.jp.

ABSTRACT
We herein report an extremely rare case of ductal carcinoma in situ (DCIS) arising in tubular adenoma of the breast. A 33-year-old female first noticed a mass in her right breast when she was 15 years old. The tumor had not changed in size subjectively for 18 years. She finally visited the hospital one and a half years before this presentation for an examination of her breast mass. Ultrasonography (US) showed a circumscribed mass suggesting a benign tumor, and mammography (MMG) revealed the well-defined high-density mass with a focal region of microcalcification. It was suspected to be adenosis based on a core-needle biopsy (CNB). During the regular follow-up, the microcalcification in the mass increased. She was therefore referred to our hospital for further examination. US and MMG showed a well-demarcated mass with a focal microcalcified area. US-guided CNB diagnosed it as DCIS with tubular adenoma. The patient underwent tumorectomy. Histologically, the tumor was diagnosed to be DCIS in tubular adenoma with negative surgical margins.

No MeSH data available.


Related in: MedlinePlus

The tumor comprised two parts, with an indistinct border between them. a The main part of the tumor showed proliferation of uniform small ducts that were composed of double layers of epithelial cells and myoepithelial cells with a small amount of stroma. It was diagnosed to be tubular adenoma. b The other part consisted of neoplastic epithelial proliferation, in which microlumens were formed containing cellular debris and calcification that was detected on MMG. The microlumens were surrounded by homogeneous low-grade cuboidal to low columnar cells. It was diagnosed to be intraductal carcinoma
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Fig4: The tumor comprised two parts, with an indistinct border between them. a The main part of the tumor showed proliferation of uniform small ducts that were composed of double layers of epithelial cells and myoepithelial cells with a small amount of stroma. It was diagnosed to be tubular adenoma. b The other part consisted of neoplastic epithelial proliferation, in which microlumens were formed containing cellular debris and calcification that was detected on MMG. The microlumens were surrounded by homogeneous low-grade cuboidal to low columnar cells. It was diagnosed to be intraductal carcinoma

Mentions: Because the carcinoma part was suggested to be surrounded by a benign tumor, we performed tumorectomy. The tumor measured 4.7 × 4.0 × 2.2 cm in the greatest dimensions, and the cut surface showed a white part within a yellowish nodule, which was much the same as the hyperechoic area on US and the calcified area on MMG (Fig. 3). Histologically, the tumor comprised two parts, with an indistinct border between them. The main part showed proliferation of uniform small ducts that were composed of double layers of epithelial cells and myoepithelial cells with a small amount of stroma (Fig. 4a). These tumor cells had round to oval nuclei with inconspicuous nucleoli, and lacked cytological atypia. Based on these findings by hematoxylin and eosin stain, it was diagnosed to be tubular adenoma. The MIB-1 index of epithelial cells was 13.9 %. The other part consisted of neoplastic epithelial proliferation with solid and cribriform patterns, in which the microlumens were formed containing cellular debris and granular or psammomatous calcification that was detected on MMG. There was no comedo necrosis. The microlumens were surrounded by homogeneous cuboidal to low columnar cells of low nuclear grade. This part was diagnosed to be intraductal carcinoma. The histological transition between DCIS and tubular adenoma was not determined, but DCIS existed within the tubular adenoma and had spread into it (Fig. 4b). The surgical margin was negative. The histological boundary between this tubular adenoma and the surrounding breast tissue was clear, and there was no cancerous tissue around it. The patient underwent no further treatment after surgery.Fig. 3


Ductal carcinoma in situ arising in tubular adenoma of the breast.

Saimura M, Anan K, Mitsuyama S, Ono M, Toyoshima S - Breast Cancer (2012)

The tumor comprised two parts, with an indistinct border between them. a The main part of the tumor showed proliferation of uniform small ducts that were composed of double layers of epithelial cells and myoepithelial cells with a small amount of stroma. It was diagnosed to be tubular adenoma. b The other part consisted of neoplastic epithelial proliferation, in which microlumens were formed containing cellular debris and calcification that was detected on MMG. The microlumens were surrounded by homogeneous low-grade cuboidal to low columnar cells. It was diagnosed to be intraductal carcinoma
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Related In: Results  -  Collection

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Fig4: The tumor comprised two parts, with an indistinct border between them. a The main part of the tumor showed proliferation of uniform small ducts that were composed of double layers of epithelial cells and myoepithelial cells with a small amount of stroma. It was diagnosed to be tubular adenoma. b The other part consisted of neoplastic epithelial proliferation, in which microlumens were formed containing cellular debris and calcification that was detected on MMG. The microlumens were surrounded by homogeneous low-grade cuboidal to low columnar cells. It was diagnosed to be intraductal carcinoma
Mentions: Because the carcinoma part was suggested to be surrounded by a benign tumor, we performed tumorectomy. The tumor measured 4.7 × 4.0 × 2.2 cm in the greatest dimensions, and the cut surface showed a white part within a yellowish nodule, which was much the same as the hyperechoic area on US and the calcified area on MMG (Fig. 3). Histologically, the tumor comprised two parts, with an indistinct border between them. The main part showed proliferation of uniform small ducts that were composed of double layers of epithelial cells and myoepithelial cells with a small amount of stroma (Fig. 4a). These tumor cells had round to oval nuclei with inconspicuous nucleoli, and lacked cytological atypia. Based on these findings by hematoxylin and eosin stain, it was diagnosed to be tubular adenoma. The MIB-1 index of epithelial cells was 13.9 %. The other part consisted of neoplastic epithelial proliferation with solid and cribriform patterns, in which the microlumens were formed containing cellular debris and granular or psammomatous calcification that was detected on MMG. There was no comedo necrosis. The microlumens were surrounded by homogeneous cuboidal to low columnar cells of low nuclear grade. This part was diagnosed to be intraductal carcinoma. The histological transition between DCIS and tubular adenoma was not determined, but DCIS existed within the tubular adenoma and had spread into it (Fig. 4b). The surgical margin was negative. The histological boundary between this tubular adenoma and the surrounding breast tissue was clear, and there was no cancerous tissue around it. The patient underwent no further treatment after surgery.Fig. 3

Bottom Line: During the regular follow-up, the microcalcification in the mass increased.She was therefore referred to our hospital for further examination.US and MMG showed a well-demarcated mass with a focal microcalcified area.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Kitakyushu Municipal Medical Center, 2-1-1 Bashaku, Kokurakita-ku, Kitakyushu, Fukuoka, 802-0077, Japan, msaimura@med.kyushu-u.ac.jp.

ABSTRACT
We herein report an extremely rare case of ductal carcinoma in situ (DCIS) arising in tubular adenoma of the breast. A 33-year-old female first noticed a mass in her right breast when she was 15 years old. The tumor had not changed in size subjectively for 18 years. She finally visited the hospital one and a half years before this presentation for an examination of her breast mass. Ultrasonography (US) showed a circumscribed mass suggesting a benign tumor, and mammography (MMG) revealed the well-defined high-density mass with a focal region of microcalcification. It was suspected to be adenosis based on a core-needle biopsy (CNB). During the regular follow-up, the microcalcification in the mass increased. She was therefore referred to our hospital for further examination. US and MMG showed a well-demarcated mass with a focal microcalcified area. US-guided CNB diagnosed it as DCIS with tubular adenoma. The patient underwent tumorectomy. Histologically, the tumor was diagnosed to be DCIS in tubular adenoma with negative surgical margins.

No MeSH data available.


Related in: MedlinePlus