Abstract
Breast spiradenoma is extremely rare, with only 4 cases reported previously. We describe an instructive case of breast spiradenoma resembling adenoid cystic carcinoma (AdCC). A 71-year-old woman underwent excisional biopsy of a breast mass after a conclusive diagnosis was unable to be obtained from core needle biopsy showing an AdCC-like pattern. Histopathologically, the lesion demonstrated solid and cribriform foci comprising basaloid cells, luminal cells, and eosinophilic hyaline material, reminiscent of solid-basaloid AdCC, alongside convoluted lumens, stromal edema, lymphocytic infiltration, and c-kit negativity. On molecular analysis, neither MYB fusion genes nor CYLD gene abnormalities were identified. These results were supportive of spiradenoma. Salivary gland– and skin adnexal–type tumors are challenging to diagnose due to morphological overlaps. This case, highlighting histopathological and molecular features, shows that breast spiradenoma can be a diagnostic pitfall among the differential diagnoses of AdCC.
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References
Who Classification of Tumours Editorial Board (ed) (2019) WHO classification of tumours of the breast, 5th edn. International Agency for Research on Cancer, Lyon
Nakamura K, Aimono E, Tanishima S, Imai M, Nagatsuma AK, Hayashi H, Yoshimura Y, Nakayama K, Kyo S, Nishihara H (2020) Intratumoral genomic heterogeneity may hinder precision medicine strategies in patients with serous ovarian carcinoma. Diagnostics (Basel) 10:E200. https://doi.org/10.3390/diagnostics10040200
Arpino G, Clark GM, Mohsin S, Bardou VJ, Elledge RM (2002) Adenoid cystic carcinoma of the breast: molecular markers, treatment, and clinical outcome. Cancer 94:2119–2127
Ribeiro-Silva A, Shaletich C, Careta RS, Kazava DK, Siqueira MC, Ponton F (2004) Spiradenocarcinoma of the breast arising in a long-standing spiradenoma. Ann Diagn Pathol 8:162–166
Saboorian MH, Kenny M, Ashfaq R, Albores-Saavedra J (1996) Carcinosarcoma arising in eccrine spiradenoma of the breast. Report of a case and review of the literature. Arch Pathol Lab Med 120:501–504
Panico L, D'Antonio A, Chiacchio R, Delrio P, Petrella G, Pettinato G (1996) An unusual, recurring breast tumor with features of eccrine spiradenoma: a case report. Am J Clin Pathol 106:665–669
Bosch MM, Boon ME (1992) Fine-needle cytology of an eccrine spiradenoma of the breast: diagnosis made by a holistic approach. Diagn Cytopathol 8:366–368
D'Alfonso TM, Mosquera JM, MacDonald TY, Padilla J, Liu YF, Rubin MA, Shin SJ (2014) MYB-NFIB gene fusion in adenoid cystic carcinoma of the breast with special focus paid to the solid variant with basaloid features. Hum Pathol 45:2270–2280. https://doi.org/10.1016/j.humpath.2014.07.013
Poling JS, Yonescu R, Subhawong AP, Sharma R, Argani P, Ning Y, Cimino-Mathews A (2017) MYB labeling by immunohistochemistry is more sensitive and specific for breast adenoid cystic carcinoma than MYB labeling by FISH. Am J Surg Pathol 41:973–979. https://doi.org/10.1097/PAS.0000000000000878
Fehr A, Kovács A, Löning T, Frierson H Jr, van den Oord J, Stenman G (2011) The MYB-NFIB gene fusion-a novel genetic link between adenoid cystic carcinoma and dermal cylindroma. J Pathol 224:322–327. https://doi.org/10.1002/path.2909
Rashid M, van der Horst M, Mentzel T, Butera F, Ferreira I, Pance A, Rütten A, Luzar B, Marusic Z, de Saint AN, Ko JS, Billings SD, Chen S, Abi Daoud M, Hewinson J, Louzada S, Harms PW, Cerretelli G, Robles-Espinoza CD, Patel RM, van der Weyden L, Bakal C, Hornick JL, Arends MJ, Brenn T, Adams DJ (2019) ALPK1 hotspot mutation as a driver of human spiradenoma and spiradenocarcinoma. Nat Commun 10:2213. https://doi.org/10.1038/s41467-019-09979-0
Leonard N, Chaggar R, Jones C, Takahashi M, Nikitopoulou A, Lakhani SR (2001) Loss of heterozygosity at cylindromatosis gene locus, CYLD, in sporadic skin adnexal tumours. J Clin Pathol 54:689–692
Ho AS, Kannan K, Roy DM, Morris LG, Ganly I, Katabi N, Ramaswami D, Walsh LA, Eng S, Huse JT, Zhang J, Dolgalev I, Huberman K, Heguy A, Viale A, Drobnjak M, Leversha MA, Rice CE, Singh B, Iyer NG, Leemans CR, Bloemena E, Ferris RL, Seethala RR, Gross BE, Liang Y, Sinha R, Peng L, Raphael BJ, Turcan S, Gong Y, Schultz N, Kim S, Chiosea S, Shah JP, Sander C, Lee W, Chan TA (2013) The mutational landscape of adenoid cystic carcinoma. Nat Genet 45:791–798. https://doi.org/10.1038/ng.2643
Fusco N, Colombo PE, Martelotto LG, De Filippo MR, Piscuoglio S, Ng CK, Lim RS, Jacot W, Vincent-Salomon A, Reis-Filho JS, Weigelt B (2016) Resolving quandaries: basaloid adenoid cystic carcinoma or breast cylindroma? The role of massively parallel sequencing. Histopathology 68:262–271. https://doi.org/10.1111/his.12735
Acknowledgments
We sincerely thank Emmy Yanagida and Hiroshi Yamada for their skillful technical assistance.
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NA provided clinical information and specimens. HM and NA wrote the manuscript. RT performed and analyzed MYB FISH and NGS. TPH provided opinions for diagnosis and manuscript review. All authors made substantial contributions to the conception, design, and drafting of the work.
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This study was part of a research project approved by the ethics committees at Nakagami Hospital (2016028-1).
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Matsumoto, H., Takamatsu, R., Abe, N. et al. Spiradenoma of the breast: a rare diagnostic pitfall in the evaluation of solid-basaloid breast lesions with a dual cell population. Virchows Arch 479, 401–405 (2021). https://doi.org/10.1007/s00428-020-02958-7
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DOI: https://doi.org/10.1007/s00428-020-02958-7