Background: Contrast-enhanced spectral mammogram (CESM) is a modern technique providing additional
information to detect or diagnose the breast cancers.
Introduction: We present a rare ACC of breast on CESM.
Methods: A 49-year-old woman with surgicopathological proved ACC is reported with features on CESM, sonography
and contrast-enhanced magnetic resonance imaging (CE-MRI).
Results: Sonography revealed a 1.4 cm × 1.2 cm × 1 cm circumscribe round mass in the upper outer quadrant of the left
breast that was diagnosed to fibroadenoma. The mammogram did not show any discernible mass, however the
recombined subtracted images displayed a circumscribe mass with thin rim enhancement and enhanced internal patches
that were resembling to CE-MRI. Finally, the mass was proved to ACC.
Conclusion: CESM facilitates detection of an isodense cancer and provides the enhanced features for differential
diagnosis. Resembling CE-MRI, CESM displayed rim enhancement and internal enhanced patches as diagnostic clues for
this case of ACC.