Malignant Adenomyoepithelioma of the Breast with Soft Tissue Metastasis and an Aggressive Course: A Rare Case Report

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Malignant adenomyoepithelioma (M-AME) of the breast is an extremely rare neoplasm. It demonstrates a wide range of morphological features and clinical behaviors, including the potential for distant metastasis. We present a 41-year-old female patient who was initially diagnosed with an intraductal papilloma on tru-cut biopsy. Surgical excision revealed multiple tumors exhibiting features consistent with MAME, including in situ and invasive components. During follow-up, the patient developed multiple lung metastases and, notably, a soft tissue metastasis in the anterior tibial region. The metastatic lesion showed a purely epithelioid morphology. Molecular analysis revealed a PIK3CA H1047R mutation. This case represents the youngest reported patient with soft tissue metastasis of M-AME, highlighting the aggressive nature and metastatic potential of this rare tumor. Given the lack of effective systemic therapies, multidisciplinary management and further research are essential to guide treatment strategies for M-AME.

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