Tubular adenoma of the breast: a rare presentation and review of the literature

Abstract

Tubular adenomas, also known as pure adenomas, are rare epithelial tumors of the breast. Only a few cases have been reported in the literature, especially in young women of reproductive age. Postmenopausal women are very rarely affected. We describe here a very rare case of tubular breast adenoma in a postmenopausal woman who presented with a gradually enlarging breast lump. Clinical examination and imaging studies revealed a non-tender well circumscribed left breast tumor suggestive of a fibroadenoma. Due to the history of progressive enlargement of the breast lump, a surgical excision was performed. Histological findings were suggestive of a tubular breast adenoma. We conclude that although tubular breast adenoma is rare, it should always be considered in the differential diagnosis in postmenopausal patients presenting with a gradually enlarging breast mass. Preoperative diagnosis is difficult because tubular adenoma is indistinguishable from a fibroadenoma on physical examination and breast imaging. Surgical excision is necessary to establish a definitive diagnosis. Clinical presentation and management of our patient are discussed along with a review of the literature.

Keywords: Tubular adenoma; Breast; Breast mass.

Figure 1

Left mediolateral oblique mammogram shows a multilobulated, well-circumscribed mass without calcifications, suggestive of a fibroadenoma.

Figure 2

Ultrasonography shows a slightly lobulated hogogenous hypoechoic mass with slight posterior acoustic enhancement, without calcifications.

Figure 3

Photomicrograph showing closely approximated round or oval glandular structures. The glandular proliferation has a pattern that resembles tubular adenosis. There is a single layer of epithelium supported by a layer of myoepithelial cells. A small amount of secretion is present in the glandular lumens H&E stain, (original magnification × 100).