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Adenomyoepithelioma (AME) is an uncommon breast tumor distinguished by the presence of both epithelial and myoepithelial cell proliferation. It often presents clinically as a well-circumscribed, non-painful mass, although it can also be asymptomatic and discovered incidentally during imaging. This case report describes a 32-year-old woman with a tumor that progressively increased in size. It was initially assessed as a fibroadenoma based on ultrasonography and MRI, as the patient declined to undergo a core needle biopsy. The tumor poses significant diagnostic challenges due to its diverse imaging characteristics, necessitating a core needle biopsy for initial identification. There is also considerable variability within different regions of the same tumor, and surgical removal is typically recommended for most cases of AME. Most AMEs are benign, but they have the potential for local recurrence after surgical excision and, in rare cases, can become malignant. Accurate diagnosis and appropriate management can be achieved through clinical suspicion during examination, combined with the use of radiological techniques and histopathological analysis., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Rellias et al.)