Adenomyoepithelioma of the breast: a rare diagnosis complicated by surgical emergency and diagnostic uncertainty

A woman in her 80s was referred as an emergency case with a large oedematous and ulcerating lesion of the right breast. There was a 5-month history of increasing breast volume with new onset skin breakdown and discharge. Imaging revealed an extensive heterogeneous mass requiring drainage. No diagnos...

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Bibliographic Details
Published in:BMJ case reports 2022-02, Vol.15 (2), p.e246390
Main Authors: Ford, Christopher Michael, Regan, Hilary, Dwyer, Moyna, Patel, Gaurel
Format: Article
Language:English
Subjects:
Adenomyoepithelioma - diagnostic imaging
Adenomyoepithelioma - surgery
Biopsy
Breast - diagnostic imaging
Breast - surgery
Breast cancer
Breast Neoplasms - diagnosis
Breast Neoplasms - surgery
Case reports
Case Reports: Rare disease
Female
Humans
Lymphatic system
Mammography
Mastectomy
Medical diagnosis
Microscopy
Sepsis
Surgery
Ultrasonic imaging
Uncertainty
Citations: Items that this one cites
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Description
Summary:A woman in her 80s was referred as an emergency case with a large oedematous and ulcerating lesion of the right breast. There was a 5-month history of increasing breast volume with new onset skin breakdown and discharge. Imaging revealed an extensive heterogeneous mass requiring drainage. No diagnosis was received from multiple biopsies and immediate surgical resection of the breast and axillary sampling was prioritised given the deteriorating patient condition. Postoperative histology identified a biphasic Adenomyoepithelioma of low malignant potential, a rare presentation compounding the complexity of management. The diagnostic uncertainty of this case highlighted the importance of MDT collaboration and the flexibility of current management pathways when dealing with cases requiring urgent surgical intervention. Axillary sampling in the context of unsuccessful preoperative biopsy represented a comprehensive means for assessing the need for further surgical or systemic management in the context of unconfirmed malignancy in a deteriorating patient.
ISSN:1757-790X
1757-790X
DOI:10.1136/bcr-2021-246390