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 Table of Contents  
CASE REPORT
Year : 2021  |  Volume : 35  |  Issue : 1  |  Page : 40-41

Tubular adenoma of the breast: A rare entity


1 Department of Surgery, Jnims, Imphal, Manipur, India
2 Department of Pathology, Jnims, Imphal, Manipur, India
3 Department of Pastic and Reconstructive Surgery, Afmc, Pune, Maharashtra, India

Date of Submission05-Jan-2021
Date of Acceptance19-Jun-2021
Date of Web Publication04-Aug-2021

Correspondence Address:
Moirangthem Henary Singh
Department of Pathology, JNIMS, Imphal - 795 005, Manipur
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jms.jms_6_21

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  Abstract 


Tubular adenoma is a rare benign neoplasm of the breast. It is commonly seen in premenopausal women and has no association with an increased risk of breast cancer. It is difficult to diagnose tubular adenoma clinically, radiologically, and cytologically. Histopathological examination remains the gold standard in diagnosing tubular adenoma.

Keywords: Fibroadenoma, histopathology, tubular adenoma


How to cite this article:
Simon L R, Singh MH, Laiphrakpam A, Devi L S. Tubular adenoma of the breast: A rare entity. J Med Soc 2021;35:40-1

How to cite this URL:
Simon L R, Singh MH, Laiphrakpam A, Devi L S. Tubular adenoma of the breast: A rare entity. J Med Soc [serial online] 2021 [cited 2021 Oct 26];35:40-1. Available from: https://www.jmedsoc.org/text.asp?2021/35/1/40/323164




  Introduction Top


Tubular adenoma is one of the rarest benign neoplasms of the breast, accounting for only 0.13%–1.7% of all benign breast neoplasms.[1] It is typically seen in women of reproductive age group. It is difficult to diagnose and differentiate it from other benign lesions (fibroadenoma) and malignant breast cancer (tubular carcinoma) on the basis of physical examination, imaging studies, and aspiration cytology. A definite diagnosis can be established only after histopathological examination. Only a few cases are reported in the current literature, and as such, it is not a well-known entity among clinicians.[2] Here, we report a case of tubular adenoma clinically diagnosed as fibroadenoma.


  Case Report Top


A 16-year-old girl presented with a complaint of gradually enlarging painless lump in the (L) breast of 8-month duration. There is no history of any associated nipple discharge or skin changes. There was no history of breast malignancy in the family. No known comorbidities were present. Physical examination revealed a firm, nontender, freely mobile, well-defined lump of size 2 cm × 1.5 cm in the upper outer quadrant of the (L) breast. There were no palpable axillary or supraclavicular lymph nodes. Another systemic examination was unremarkable. A clinical diagnosis of fibroadenoma was made, supported by fine-needle aspiration cytology and sonographic findings, and the patient underwent excision biopsy. Histopathological examination revealed it to be a case of tubular adenoma [Figure 1] and [Figure 2]. The postoperative period was uneventful.
Figure 1: Tubular adenoma showing tightly packed homogenous tubular and acinar epithelial components with sparse stroma (H and E, ×10)

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Figure 2: Tubular adenoma showing attenuated myoepithelial cell layer (H and E, ×40)

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  Discussion Top


Tubular adenomas are rare benign epithelial tumors of the breast, and in 90% of the cases, it occurs in women below 40 years of age, although there are reported cases of tubular adenoma occurring in postmenopausal women.[2] Tubular adenoma resembles fibroadenoma clinically as well as on imaging studies and usually presents as a painless, freely mobile, well-defined breast mass with no skin or nipple alterations.[3] A differentiation from fibroadenoma can only be made histologically. Tubular adenomas are characterized by the presence of tightly packed homogenous tubular and acinar epithelial components with sparse stroma while fibroadenomas show abundant stroma. The tubules are lined by a single layer of epithelial cells with an attenuated myoepithelial layer.

Preoperative diagnosis of tubular adenoma is extremely difficult because, in majority of the cases, the physical findings and imaging features are nonspecific. Radiologically, it resembles noncalcified fibroadenomas in younger women, while in older women, microcalcifications may be present resembling malignancy. The presence of both tubular adenoma and fibroadenoma has been reported suggesting a close relation of the two processes.[4] Reports of tubular adenoma occurring in accessory breast have also been described in the literature.[5]

However, tubular adenoma is a completely benign tumor and is not known to be associated with an increased risk of breast cancer. Even reported cases of association between carcinoma and tubular adenoma showed generally histologically demarcated lesions and seemed to be a collision between a separate tubular adenoma and an invasive carcinoma.


  Conclusion Top


Tubular adenomas of the breast are rare benign epithelial tumors most commonly seen in young women of reproductive age. Preoperative diagnosis is difficult as physical findings and imaging studies are nonspecific. Surgical excision followed by histopathological examination is needed to arrive at a definite diagnosis and is the treatment of choice. Despite its rarity, it is important for surgeons to keep this entity in mind during diagnostic evaluation of breast lesions in order to avoid unnecessary aggressive treatment and the entailing morbidity and mortality.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Lakhani SR, Ellis IO, Schnitt SJ, Tan PH, Van de Vijver MJ, editors. WHO Classification of Tumours of the Breast. 4th ed. Lyon, France: IARC; 2012.  Back to cited text no. 1
    
2.
Salemis NS, Gemenetis G, Karagkiouzis G, Seretis C, Sapounas K, Tsantilas V et al. Tubular adenoma of the breast: a rare presentation and review of the literature. J clin Med Res2012;4:64-7.  Back to cited text no. 2
    
3.
Huang Y, Zhang H, Zhou Q, Ling L, Wang S. Giant tubular adenoma of the accessory breast in the anterior chest wall occurred in a pregnant woman. Diagn Pathol 2015;10:60.  Back to cited text no. 3
    
4.
Soo MS, Dash N, Bentley R, Lee LH, Nathan G. Tubular adenomas of the breast: imaging findings with histologic correlation. AJR Am J Roentgenol 2000;174:757-61.  Back to cited text no. 4
    
5.
Kalipatnapu S, Samuel V, Johnson M, Perookavil Daniel K. A case report of a giant tubular adenoma with a concurrent fibroadenoma of the breast. World J Oncol 2015;6:502-3.  Back to cited text no. 5
    


    Figures

  [Figure 1], [Figure 2]



 

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