A tumor diameter of 3 cm or greater appears to be associated with a higher likelihood of malignancy. Phyllodes tumours of the breast are characterized by having both an epithelial as well as stromal component and these usually comprise almost 3% of all fibroepithelial tumours. The term cystosarcoma phyllodes was coined by johannes muller in 1838 to describe the gross appearance of this cystic, fleshy, leafy, tumor of the breast, which he clearly stated to be a benign tumor. Malignant phyllodes tumor is a rare and aggressive fibroepithelial neoplasm. Phyllodes tumor page 1 of 4 md anderson cancer center. This is the case regardless of whether they are benign or malignant. Phyllodes tumor pt of the breast is a rare fibroepithelial neoplasm, accounting for 0.
To the best of our knowledge, there are only three case reports regarding this in the available literature. After histopathological examination, it was diagnosed as borderline phyllodes tumor with extensive squamous metaplasia. The stroma is markedly cellular and the stromal cells show marked nuclear pleomorphism. Phyllodes tumors of the breast are rare, accounting for less than 1% of all breast tumors. The histologic characteristics of the stroma and glands typically differ from one region to the next, and so does the relationship between these components fig.
About 20% of the cases grow beyond 10 cm giant phyllodes tumor and rarely attain size of 40 cm when it is a unique challenge to the surgeon with respect to treatment options. Pdst is distinguished from phyllodes tumor by its lack of leaflike architecture. Phyllodes tumors of the breast american cancer society. Fibroadenoma is the most prevalent benign breast lesion that generally affects middleaged women. The current study used a large population database to determine prognostic factors that predict cause. The phyllodes tumor, a lesion limited to mammary tissue, was first described by muller in 1838. A low magnification of the primary breast phyllodes tumour with a cystic space into which stromal fronds projected. Last month i had a partial mastectomy for a highgrade malignant phyllodes tumor. Extensive squamous metaplasia within phyllodes tumor is rare and may occur in benign, borderline and malign subtypes.
The name phyllodes, which is taken from the greek language and means leaflike, refers to that fact that the tumor cells grow in a leaflike pattern. Incidentally discovered extensive squamous metaplasia. Phyllodes tumor of the breast genetic and rare diseases. The tumor is rarely found in adolescents and the elderly.
They are exceptional in this aspect to convert into a stromal sarcoma of the breast after multiple recurrences. Malignant phyllodes tumor of the female breast macdonald. Overlying skin may display a shiny appearance and be translucent enough to reveal underlying breast veins. Phyllodes tumors grow in the connective tissue of the breast, called the stroma. Stained slide showing microphotograph of phyllodes tumor. Phyllodes tumours are rare fibroepithelial lesions that account for less than 1% of all breast neoplasms. The goal of successful managing this tumor is early detection and complete resection prior to dissemination. This includes the tissue and ligaments that surround the ducts. The most common site of phyllodes tumor is the breast in general, phyllodes tumor may be classified as benign, malignant, or borderline tumor based on. Journal of surgery case reports 26 2016 96100 contents lists available at sciencedirect international journal of surgery case reports journal homepage. Phyllodes tumor pt of the breast is a rare disease usually presents as a large lump. Co m, chen c, tsang jy et al mammary phyllodes tumour. There is substantial overlap in the imaging characteristics of benign and malignant phyllodes tumors.
Phyllodes tumors pts are rare fibroepithelial tumors of the breast. They are also associated with a higher rate of recurrence than their benign counterparts. The phyllodes tumor is a rare fibroepithelial tumor, usually benign and rapidly growing, which usually acquires a large size, with characteristics similar to fibroadenoma but with a. Low grade malignant borderline phyllodes tumor of the. Phyllodes tumors are uncommon and unpredictable mayo. However, in the setting where additional recurrence would create significant. Phyllodes tumor of the breast is a rare biphasic tumor accounting for less than 1% of all primary breast tumors.
Phyllodes tumor is attributed to a small fraction of primary tumors of the breast. Phyllodes tumor, also known as cystosarcoma phyllodes, is a rare fibroepithelial tumor of the breast which has some resemblance to a fibroadenoma. Most phyllodes tumors are benign not cancer, but about 1 out of 4 of these tumors are malignant cancer. Klinisch zeigen diese tumoren ein unterschiedliches, haufig sehr. Pathology outlines who classification of breast tumors. Phyllodes tumors are most common in women in their 40s, but women of any age can have them.
Malignant phyllodes tumour with metastasis to the lung. Phyllodes tumors constitute a group of rare epithelial lesions of the breast which mainly develops at around 4050 years. Malignant phyllodes tumor of breast is a rare tumor of the breast, which is observed in middleaged individuals mostly women. Ein phylloidtumor oder cystosarcoma phylloides ist mit einem.
Surgical management of phyllodes tumors oncology jama. We will be providing unlimited waivers of publication charges for accepted articles related to covid19. Distinction of benign phyllodes tumours from cellular fibroadenomas is fraught. Synchronous bilateral breast benign phyllodes tumors in an.
In past medical history, the patient had left breast surgery due to fibrocystic change seven years ago. Some doctors feel that an even wider margin of healthy tissue should be removed. Althoughmany types of breast cancer can cause a lump in the breast. A very large phyllodes tumor may erode through overlying skin and present as an external fungating breast mass. Current trends in the management of phyllodes tumors of. Please use one of the following formats to cite this article in your essay, paper or report. We report an unusual fungating lesion with a diagnostic challenge.
Malignant phyllodes tumor presenting in bone, brain, lungs, and. Phyllodes derived from the greek word phyllon meaning leaf, and eidos meaning form. Removal of well differentiated liposarcoma as a histologic criterion for malignancy in phyllodes tumor in the absence of additional supporting features updated information on molecular pathology, expression profiling and molecular classification of breast tumors, however, focus remains on morphologic classification. Such tumors occur rarely in pregnancy and lactation. The stroma is moderately cellular and the stromal cells show moderate nuclear atypia hematoxylineosin, original magnifications 340 a and d, 320 b and f, 310 c, and 3100 e and g. An accurate diagnosis of metastases should be based on clinicopathological correlation allowing exclusion of differential diagnoses.
They account for less than 1% of all breast neoplasms. These cancers arecalled sarcomas4 and lymphomas5 and are not really thought of asbreast cancers. My oncologist said its up to me if i want radiation, since its only recently being used more frequently for this type of cancer. In their least aggressive form, phyllodes tumors behave like benign fibroadenomas, although with a propensity to recur locally following excision without wide margins. Core needle biopsy was opined as phyllodes tumor with lactational changes, and subsequent wide local excision confirmed the diagnosis of benign phyllodes tumor with. In this report, we presented a case of a 45yearold female with ulcerating breast lesion characteristic of locally advanced breast cancer. The classification of pt proposed by the world health organization who into benign, borderline, and malignant is based on a combination of several histologic features, including stromal cellularity. In fact phyllodes tumors comprise less than 1% of all breast tumors. Malignant phyllodes cases were identified using surveillance epidemiology and end results database. First, this is a rare entity so there is less familiarity with the tumor within the medical community. Early diagnosis with proper surgical management can. Welcome to cancer chat mcvikki although im sorry for the reason youve joined us.
Phyllodes tumor in a lactating breast semantic scholar. Curiously, phyllodes tumors tend to involve the left breast more commonly than the right. It is a rare condition, with an incidence of 1 in 100,000, and its cause remains unclear. Since phyllodes tumors are locally recurrent tumor especially when not excised with a clear margins and very u n p r e d i c t a b l ei ng r o w t ha n dm e t a s t a t i ca c t i v i t y,i ti sv. Because these tumors can come back if enough normal tissue is not removed, surgery should involve removing the tumor and at least 1 cm of the surrounding tissue. Phyllodes tumours are rare fibroepithelial lesions. In certain areas, the proliferating fibroblasts of the phyllodes tumor remain confined to the specialized stromal compartment fig. Borderline phyllodes tumor of breast is a rare tumor of the breast, which is observed in middleaged individuals mostly women. Phyllodes tumors are rare fibroepithelial neoplasms that account for 0. Pdf the largest and neglected giant phyllodes tumor of the breast.
Malignant phyllodes tumor is a rare and potentially aggressive breast neoplasm. The size varies from 1 to 41 cm with an average of 74cm. Malignant phyllodes tumors tend to progress rapidly though only 1. Thereare also other types of breast cancer that are less common like phyllodes tumor and angiosarcoma a small number of cancers start in other tissues in thebreast. With the nonoperative management of fibroadenomas widely adopted, the importance of phyllodes tumours today lies in the need to differentiate them from other benign breast lesions.
Similarly, separation of the malignant phyllodes tumour from spindle cell metaplastic carcinoma and primary. Bone metastasis from malignant phyllodes breast tumor. Phyllodes tumors of the breast are rare fibroepithelial lesions that comprise less than 1% of all breast malignancies. Differentiation between phyllodes tumors and fibroadenomas based on mammographic sonographic and mri features. Primary breast neoplasms are rare in adolescent females, most of which are benign. Table of contents 2016 case reports in pathology hindawi. Development of mouse models of malignant phyllodes tumors by transplantation of syngeneic mammary gland cells expressing mutant h. Phyllodes tumor of the breast is one of the more confusing of the diagnoses encountered in the breast. A 55yearold lady was admitted to the surgery ward with left breast mass since 23 months ago. Recurrent giant fibroadenomas with transformation to.
We are committed to sharing findings related to covid19 as quickly and safely as possible. We used chisquare tests to compare characteristics between racial groups and multinomial logistic regression to calculate relative risk ratios rrr and 95% confidence intervals ci comparing the likelihood of having particular characteristics by race. Phyllodes tumors constitute a remarkably small subset of breast neoplasms 0. Histopathologic features, differential diagnosis, and. A read is counted each time someone views a publication summary such as the title, abstract, and list of authors, clicks on a figure, or views or downloads the fulltext. All breast lumps should be triple assessed and the diagnosis of a phyllodes tumour considered in women. Women with lifraumeni syndrome a rare, inherited genetic condition have an increased risk for phyllodes tumors. Pdf phyllodes tumors are rare fibroepithelial tumors that account for less than 0. However, multiple recurrences of rapidly enlarging fibroadenomas suggest a high possibility of transforming into phyllodes tumors, which are uncommon fibroepithelial lesions that account for. It is typically a large, fast growing mass that forms from the periductal stroma of the breast. Division of gene regulation, institute for advanced medical research, keio university school of medicine, 35 shinano. This tumor was first described in 1774 as a giant type of fibroadenoma and was first named as cystosarcoma phyllodes by johannes muller in 1838.
Phyllodes tumor of the breast archives of pathology. Phyllodes tumor is a rare breast fibroepithelial tumor that usually present with a palpable lump or picked up on a routine imaging. Development of mouse models of malignant phyllodes tumors. Phyllodes tumors are uncommon fibroepithelial breast tumors that are capable of a diverse range of biologic behaviors. Surgery is the main treatment for phyllodes tumors of the breast. We report a case of a 25yearold lactating mother presenting with a lump in the left breast.