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Case Report Open Access

Malignant adenomyoepithelioma with HRAS G13R mutation: A case report

  • Authors:
    • Hiroko Kuwabara
    • Reika Takeda
    • Yoshitaka Utsumi
    • Toshitaka Nagao
    • Kosei Kimura
    • Yoshinobu Hirose
    • Mitsuhiko Iwamoto
  • View Affiliations / Copyright

    Affiliations: Department of Pathology, Osaka Medical and Pharmaceutical University, Takatsuki, Osaka 569‑8686, Japan, Department of Anatomic Pathology, Tokyo Medical University, Tokyo 160‑0023, Japan, Department of Breast Surgery, Osaka Medical and Pharmaceutical University, Takatsuki, Osaka 569‑8686, Japan
    Copyright: © Kuwabara et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
  • Article Number: 122
    |
    Published online on: January 30, 2026
       https://doi.org/10.3892/ol.2026.15475
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Abstract

Adenomyoepithelioma (AME) of the breast is a rare tumor characterized by epithelial and myoepithelial differentiation, with a hotspot mutation in HRAS Q61. Malignant transformation occurs from either the luminal or myoepithelial component. In the present study, a malignant AME (M‑AME) with pulmonary metastasis is reported. M‑AME is rare, and the present report highlights the genomic alteration of primary and metastatic lesions. A 53‑year‑old Japanese woman presented to a neighboring clinic with a palpable and non‑tender mass in the left breast. The mass was suspected to be AME, and left mastectomy was performed at Osaka Medical and Pharmaceutical University (Takatsuki, Japan). Breast tumor specimens exhibited epithelial and myoepithelial proliferation with myoepithelial mitoses and necrosis, and the tumor was diagnosed as M‑AME. Following chemotherapy, a lung tumor was identified 2 years after the operation. The pulmonary tumor indicated myoepithelial cell proliferation along the bronchiolar epithelium, and myoepithelial cells exhibited clear or epithelioid features. Both the breast and lung tumor exhibited the HRAS G13R mutation, which is frequently observed in M‑AME. This mutation may be considered a driver mutation in mammary M‑AME.
View Figures

Figure 1

Microscopic findings of the breast
tumor. (A) Biphasic proliferation of myoepithelial cells and
papillary epithelial cells (hematoxylin-eosin stain; magnification,
×40). (B) High power view of (A) (hematoxylin-eosin stain;
magnification, ×100). (C) Immunohistochemistry indicated that the
myoepithelial cells were positive for p63 (magnification, ×100).
(D) Immunohistochemistry indicated that epithelial cells were
positive for GATA binding protein 3 (magnification, ×100).

Figure 2

Microscopic findings of the lung
tumor. (A) Myoepithelial cells beneath bronchiolar epithelium
(hematoxylin-eosin stain; magnification, ×200). (B)
Immunohistochemistry indicated that myoepithelial cells were
positive for p63 (magnification, ×200). (C) Immunohistochemistry
indicated that bronchiolar epithelium was positive for thyroid
transcription factor-1 (magnification, ×200).

Figure 3

DNA sequence of HRAS in (A)
breast and (B) lung tumors. Both breast and lung tumors exhibited
HRAS G13R. The arrow indicates the mutation (c.37G>C) and
the box indicates codon 13 (p.G13R).
View References

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Copy and paste a formatted citation
Spandidos Publications style
Kuwabara H, Takeda R, Utsumi Y, Nagao T, Kimura K, Hirose Y and Iwamoto M: Malignant adenomyoepithelioma with <em>HRAS</em> G13R mutation:&nbsp;A case report. Oncol Lett 31: 122, 2026.
APA
Kuwabara, H., Takeda, R., Utsumi, Y., Nagao, T., Kimura, K., Hirose, Y., & Iwamoto, M. (2026). Malignant adenomyoepithelioma with <em>HRAS</em> G13R mutation:&nbsp;A case report. Oncology Letters, 31, 122. https://doi.org/10.3892/ol.2026.15475
MLA
Kuwabara, H., Takeda, R., Utsumi, Y., Nagao, T., Kimura, K., Hirose, Y., Iwamoto, M."Malignant adenomyoepithelioma with <em>HRAS</em> G13R mutation:&nbsp;A case report". Oncology Letters 31.4 (2026): 122.
Chicago
Kuwabara, H., Takeda, R., Utsumi, Y., Nagao, T., Kimura, K., Hirose, Y., Iwamoto, M."Malignant adenomyoepithelioma with <em>HRAS</em> G13R mutation:&nbsp;A case report". Oncology Letters 31, no. 4 (2026): 122. https://doi.org/10.3892/ol.2026.15475
Copy and paste a formatted citation
x
Spandidos Publications style
Kuwabara H, Takeda R, Utsumi Y, Nagao T, Kimura K, Hirose Y and Iwamoto M: Malignant adenomyoepithelioma with <em>HRAS</em> G13R mutation:&nbsp;A case report. Oncol Lett 31: 122, 2026.
APA
Kuwabara, H., Takeda, R., Utsumi, Y., Nagao, T., Kimura, K., Hirose, Y., & Iwamoto, M. (2026). Malignant adenomyoepithelioma with <em>HRAS</em> G13R mutation:&nbsp;A case report. Oncology Letters, 31, 122. https://doi.org/10.3892/ol.2026.15475
MLA
Kuwabara, H., Takeda, R., Utsumi, Y., Nagao, T., Kimura, K., Hirose, Y., Iwamoto, M."Malignant adenomyoepithelioma with <em>HRAS</em> G13R mutation:&nbsp;A case report". Oncology Letters 31.4 (2026): 122.
Chicago
Kuwabara, H., Takeda, R., Utsumi, Y., Nagao, T., Kimura, K., Hirose, Y., Iwamoto, M."Malignant adenomyoepithelioma with <em>HRAS</em> G13R mutation:&nbsp;A case report". Oncology Letters 31, no. 4 (2026): 122. https://doi.org/10.3892/ol.2026.15475
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