Epithelioid myofibroblastoma of the breast: A case report and review of the literature

Mammary myofibroblastoma (MFB) is a rare tumour. Its clinical and pathologic characteristics have been only sporadically described. A case of epithelioid variant of MFB is reported with the diagnostic tips, the differential diagnoses, and a discussion on the possible pathogenesis. A 74 year-old woma...

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Veröffentlicht in:International journal of surgery case reports 2022-07, Vol.96, p.107382-107382, Article 107382
Hauptverfasser: Inaishi, Takahiro, Sakuma, Takahiko, Fukuoka, Tomoki, Ichihara, Shu
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Sprache:eng
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Zusammenfassung:Mammary myofibroblastoma (MFB) is a rare tumour. Its clinical and pathologic characteristics have been only sporadically described. A case of epithelioid variant of MFB is reported with the diagnostic tips, the differential diagnoses, and a discussion on the possible pathogenesis. A 74 year-old woman presented with a painless nodule in the left breast. Core needle biopsy (CNB) revealed a tumour primarily composed of epithelioid cells. Despite epithelioid appearance of the tumour cells, ductal/lobular components were absent within the tumour. As cell lineage of the epithelioid cells could not be determined with CNB, lumpectomy was performed to obtain definitive diagnosis and, at the same time, to remove the lesion. Histologically, the tumour consisted of multiple epithelioid cell nests that were spread over fibrous stroma infiltrated with adipose tissue. Spindle cells were also present, but they were fewer than epithelioid cell clusters. Occasionally, the tumour cells showed nuclear atypia. It was difficult to determine whether this tumour was benign or malignant solely with Hematoxylin-eosin stain. However, with the aid of immunohistochemical analyses, we could make a histodiagnosis of epithelioid subtype of myofibroblastoma. The differential diagnoses of epithelioid MFB include ductal, lobular, metaplastic carcinomas and mesenchymal tumours. Comprehensive knowledge of classic and variant MFB is necessary for the correct diagnosis. Pathologic diagnosis of epithelioid variant of MFB requires careful evaluation of histology and the use of a panel of immunohistochemistry. Female phenotype of breast stroma may play a role in the pathogenesis of MFB. •Breast myofibroblastoma (MFB) is a rare tumour usually composed of spindle cells.•MFB is usually diagnosed as benign but variant forms of MFB may simulate malignancy.•Epithelioid MFB may show nuclear atypia and may be confusing with epithelial tumour.•Differential diagnoses need careful histological analyses and immunohistochemistry.•Female phenotype of mammary stromal cells may play a role in the development of MFB.
ISSN:2210-2612
2210-2612
DOI:10.1016/j.ijscr.2022.107382