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September 18, 2025Open Access

Pleomorphic adenocarcinoma of the breast: a case report

YZYunkun ZhangHebei University of Engineering PFPing FanChinese Academy of Sciences MGMin GaoZhejiang Chinese Medical University

Key Points

The tumor measured 3.2 cm and was identified through ultrasound in a 74-year-old woman.
Microscopic analysis showed solid structures and cribriform patterns with significant nucleoli in tumor cells.
Immunohistochemistry indicated various markers, including negative ER and PR, and a mutation in PIK3CA was detected.
Post-surgical treatment included one course of Capecitabine, with no recurrence observed in two years.

Abstract

This article comprehensively reports a case of pleomorphic adenocarcinoma of the breast, a rare breast salivary gland-type tumor. A mass with a maximum diameter of 3.2 cm was detected through ultrasound within the upper outer quadrant in a 74-year-old woman undergoing left breast total mastectomy and sentinel lymph node exploration. Microscopically, the central part of the tumor was mostly arranged in the solid structures, some of which were cribriform and contained blue-stained secretions, while the periphery of the tumor had striated and glandular duct-like arranged structures. Some tumor cells had visible nucleoli and nuclear fission, with sparse cytoplasm. Immunohistochemistry revealed ER (-), PR (-), HER-2 (0), Bcl-2 (+), P63 (-), Calponin (-), S100 (+), E-cadherin (+), and Ki-67 (20%+). The next-generation sequencing (NGS) assay revealed a missense mutation within exon 7 in PIK3CA, which is related to the treatment of breast cancer. The patient received 1 course of oral Capecitabine treatment after surgery and was followed up for 2 years with no recurrence.

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