International Journal of Clinical Research
International Journal of Clinical Research. 2026; 10: (3) ; 10.12208/j.ijcr.20260129 .
总浏览量: 28
1广东省珠海市人民医院医疗集团超声影像科 广东珠海
2广东省产科重大疾病重点实验室，广东省妇产疾病临床医学研究中心，广州医科大学附属第三医院超声医学科 广东广州
*通讯作者： 梁伟翔,单位：广东省产科重大疾病重点实验室，广东省妇产疾病临床医学研究中心，广州医科大学附属第三医院超声医学科 广东广州; ；
腺样囊性癌（ACC）通常发生在唾液腺，发生在乳腺极其罕见，其影像学表现可类似良性病变。本病例为58岁女性，因触及右乳腺肿块一周就诊。超声检查提示右侧乳腺混合性结节BI-RADS 4B类，核磁共振成像和钼靶均评为BI-RADS 4类。穿刺病理考虑上皮-肌上皮源性肿瘤。患者行肿物切除，术后病理及免疫组化确诊为乳腺腺样囊性癌。一月余后二次手术行右侧全乳房切除+右侧腋窝前哨淋巴结活检术，切缘及前哨淋巴结均未见癌。术后随访近一年，患者未发生任何复发及转移。本病例提示，超声医师应了解乳腺腺样囊性癌的影像学表现，避免出现漏诊误诊。病理结合免疫组化有助于本病的确诊。
Adenoid cystic carcinoma usually occurs in the salivary glands, and it is extremely rare to occur in the breast. Its imaging manifestations can be similar to those of benign lesions. We report a case of a 58-year-old female who presented with a palpable mass in her right breast for one week. Ultrasound examination indicated that the mixed nodule of the right breast was classified as BI-RADS 4B, and both magnetic resonance imaging and mammography were rated as BI-RADS 4. The puncture pathology considered an epithelial-myoepithelial tumor. The patient underwent tumor resection. Postoperative pathology and immunohistochemistry confirmed the diagnosis as adenoid cystic carcinoma of the breast. More than a month later, a second operation was performed, including a total right mastectomy and a biopsy of the sentinel lymph nodes in the right axilla. No cancer was found at the resection margin or in the sentinel lymph nodes. The patient was followed up for nearly one year after the operation, and no recurrence or metastasis occurred. This case suggests that ultrasound physicians should be familiar with the imaging manifestations of adenoid cystic carcinoma of the breast to avoid missed diagnoses and misdiagnoses. Pathology combined with immunohistochemistry is helpful for the diagnosis of this disease.
[1] Santamaría G, Velasco M, Zanon G, et al. Adenoid cystic carcinoma of the breast: mammographic appearance and pathologic correlation. AJR Am J Roentgenol 1998; 171(6):1679–1683.
[2] Ghabach B, Anderson WF, Curtis RE, et al. Adenoid cystic carcinoma of the breast in the United States (1977 to 2006): a population-based cohort study. Breast Cancer Res 2010; 12(4):R54.
[3] Kashiwagi S, Asano Y, Ishihara S, Morisaki T, Takashima T, Tanaka S, Amano R, Ohsawa M, Hirakawa K, Ohira M. Adenoid cystic carcinoma of the breast: a case report. Case Rep Oncol. 2019;12(3):698–703.
[4] WHO Classification of Tumors Editorial Board. Breast tumors. Lyon (France): International Agency for Research on Cancer; 2019. (WHO classification of tumors series, 5th ed.; vol. 2).
[5] Kim J, Geyer FC, Martelotto LG, Ng C, Lim RS, Selenica P, et al. MYBL1 rearrangements and MYB amplification in breast adenoid cystic carcinomas lacking de MYB-NFIB fusion gene. J Pathol. 2018;244:143---50.
[6] Marco V, Garcia F, Rubio IT, Soler T, Ferrazza L, Roig I, Mendez I, Andreu X, Mínguez CG, Tresserra F. Adenoid cystic carcinoma and basaloid carcinoma of the breast: A clinicopathological study. Rev Esp Patol. 2021 Oct-Dec;54(4):242-249.
[7] Huang M, Jiang T, Zhao Q, You Q, Tian G, Wang B. Breast adenoid cystic carcinoma: report of a case with emphasis on routine sonographic findings and shear wave elastography. J Med Ultrason. 2018;45(1):181–184.
[8] Guldogan N, Esen G, Kayadibi Y, Taskin F, Alfatli AO, Boy FNS, Balci P, Bugdayci O, Tokat F, Ozturk T, Tunaci M, Arikan AE. Adenoid Cystic Carcinoma of the Breast: Multimodality Imaging Findings and Review of the Literature. Acad Radiol. 2023 Jun;30(6):1107-1117.
[9] Berg WA, Cosgrove DO, Doré CJ, et al. Shear-wave elastography improves the specificity of breast US: the BE1 multinational study of 939 masses. Radiology 2012;262:435-49.
[10] Arpino G, Clark GM, Mohsin S, et al. Adenoid cystic carcinoma of the breast: molecular markers, treatment, and clinical outcome. Cancer 2002; 94(8):2119–2127.