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Journal of the Korean Society of... Jul 2023Myxoid liposarcoma is an extremely rare malignant breast tumor. We report the case of a 44-year-old woman who had myxoid liposarcoma of the breast with a history of...
Myxoid liposarcoma is an extremely rare malignant breast tumor. We report the case of a 44-year-old woman who had myxoid liposarcoma of the breast with a history of phyllodes tumor and describe the imaging findings on US, mammography, and MRI. Before surgery, the mass was considered to be a recurrent phyllodes tumor. However, using US, we retrospectively identified some differences between myxoid liposarcomas and phyllodes tumors.
PubMed: 37559820
DOI: 10.3348/jksr.2022.0146 -
BMC Cancer Jan 2024Phyllodes tumor (PT) is an fibroepithelial tumor with potential for local recurrence. The optimal margin for surgical resection of PT is still debated, particularly in... (Observational Study)
Observational Study
BACKGROUND
Phyllodes tumor (PT) is an fibroepithelial tumor with potential for local recurrence. The optimal margin for surgical resection of PT is still debated, particularly in cases of positive margins. This study aimed to identify the risk factors for phyllodes tumor recurrence and the effect of a free margin on tumor recurrence by considering these risk factors.
MATERIALS AND METHODS
This is a retrospective observational study of patients diagnosed with PT who had undergone surgical management. The data were collected from medical records from 2001 to 2020 in the breast clinic of Shahid Motahhari Clinic of Shiraz. Patients were followed up for at least 3 years after the operation to be checked for local recurrence or distant metastasis at regular intervals.
RESULTS
This retrospective study included 319 patients with PT who underwent surgical management. Of these patients, 83.9% (n = 267), 7.6% (n = 24), and 8.5% (n = 27) were classified as benign, borderline, and malignant, respectively. 8.8% of all patients and 7.6% of non-malignant cases experienced local recurrence, and risk factors for recurrence included oral contraceptive use, smoking, size > 4 cm, stromal overgrowth, and stromal cell atypia. A negative surgical margin decreased the prevalence of recurrence in tumors > 4 cm and with stromal overgrowth significantly.
CONCLUSION
The study found that a negative margin in all patients did not reduce the recurrence rate in benign and borderline phyllodes tumors, suggesting close follow up as a reasonable alternative. However, a negative margin may be effective in reducing recurrence in certain high-risk groups.
Topics: Humans; Female; Phyllodes Tumor; Retrospective Studies; Neoplasm Recurrence, Local; Stromal Cells; Breast Neoplasms
PubMed: 38195454
DOI: 10.1186/s12885-023-11805-2 -
Journal of Ayub Medical College,... 2023Phyllodes tumour (PT) comprises 0.3-1% of all breast cancers and 3% of fibroepithelial neoplasm. It occurs more commonly in the fourth and fifth decades of life....
Phyllodes tumour (PT) comprises 0.3-1% of all breast cancers and 3% of fibroepithelial neoplasm. It occurs more commonly in the fourth and fifth decades of life. Fibroepithelial neoplasms are composed of cell types with two different origins, commonly mesenchymal and epithelial. Histological features are important as this forms the basis of the categorization of PT into benign, borderline and malignant types, thus facilitating management. Metaplasia in any of the two components of PT is rare and the cystic squamous type of metaplasia has even more infrequent histological features. Case: This paper presents the case of a 63-year-old female with a palpable lump in the lower outer quadrant of her left breast. Histology showed a benign Phyllodes tumour with patchy, cystic squamous metaplasia within the lesion, keratin production and foreign-body reaction in response to keratin spillage. The previously done core biopsy was also reviewed, which showed focal stromal cell condensation and features overlapping between benign and borderline phyllodes tumours. Conclusion: The case was presented because of its unique and rare histological picture of Cystic squamous metaplasia in benign PT and a further rarer finding of foreign body reaction to keratin spillage.
Topics: Humans; Female; Middle Aged; Phyllodes Tumor; Breast Neoplasms; Keratins; Metaplasia; Carcinoma, Squamous Cell
PubMed: 38404106
DOI: 10.55519/JAMC-03-11586 -
Clinical Case Reports Sep 2023Early and complete surgical resection is the most important therapeutic and diagnostic measure. Adjuvant radiation is suggested for malign phyllode tumors, phyllode...
KEY CLINICAL MESSAGE
Early and complete surgical resection is the most important therapeutic and diagnostic measure. Adjuvant radiation is suggested for malign phyllode tumors, phyllode tumors larger than 10 cm or those with a low distance to the resection margins.
ABSTRACT
Phyllodes tumors are rare fibroepithelial tumors of the breast. Histologically, they are usually classified as benign, borderline or malignant, though these classifications do not necessarily reflect the clinical course of the disease. These tumors may stay undetected for years, or show sudden and rapid progression. There is currently no consistent therapy recommendation based upon histological findings, the localization of the tumor and/or whether it is recurrent. Using the examples of three patients, we show how courses and therapy may differ widely, and discuss this in the context of the current state of the literature.
PubMed: 37663819
DOI: 10.1002/ccr3.7836 -
Cureus May 2024Benign breast diseases are a common presentation in the breast clinic outpatient department. These diseases, including giant fibroadenoma, multiple fibroadenoma in...
Benign breast diseases are a common presentation in the breast clinic outpatient department. These diseases, including giant fibroadenoma, multiple fibroadenoma in different quadrants, and large or recurrent phyllodes tumors, pose challenges in surgical management. We present a case series of 16 patients aged 19 to 63 years (average age, 41.5 years) who presented with breast lumps and underwent surgery using the round block technique for benign breast diseases at our institute between November 2019 and March 2024. Prior to surgery, all patients had clinical, radiological, and pathological assessments. Age, duration of lump, and detailed menstrual, obstetric, and family history of each patient were recorded. Eight (50%) of the patients had phyllodes tumor, four (31.25%) had fibroadenoma, three (18.75%) had both fibroadenoma and phyllodes tumor, and one (6.25%) had adenolipoma. The average size of tumors was 7.5 cm in our study. During postsurgical follow-up, none of the patients had nipple areola necrosis, and they reported that nipple sensation was acceptable. A mastectomy was avoided in all circumstances. Good cosmetic outcomes and clear margin status are achievable using the round block technique.
PubMed: 38756709
DOI: 10.7759/cureus.60416 -
Journal of Medical Ultrasound 2024The axillary tail, also known as spencer's tail or axillary process, is a continuation of tissue from the upper lateral quadrant of the breast that travels into the...
The axillary tail, also known as spencer's tail or axillary process, is a continuation of tissue from the upper lateral quadrant of the breast that travels into the axilla through a foramen of Langer in the deep fascia. Axillary inflammation or lump is a typical clinical symptom that necessitates imaging evaluation. Since the axilla consists of lymph nodes as well as nonlymphatic tissue such as accessory breast tissue, skin, fat, muscles, nerves, and blood vessels, it has a wide variety of differential diagnoses. The radiologists should be well acquainted with axillary anatomy and imaging aspects of various axillary lesions. Here, we present a 35-year-old female with a right axillary lump which was suggestive of benign tumor on ultrasonography and was proven to be benign phyllodes tumor on histopathology.
PubMed: 38665349
DOI: 10.4103/jmu.jmu_58_22 -
Advances in Radiation Oncology May 2024
PubMed: 38550370
DOI: 10.1016/j.adro.2024.101448 -
International Journal of Surgery Case... Mar 2024This case report presents a rare occurrence of multiple bilateral breast fibroadenomas, one evolving into ductal carcinoma in situ (DCIS) and invasive carcinoma,...
INTRODUCTION AND IMPORTANCE
This case report presents a rare occurrence of multiple bilateral breast fibroadenomas, one evolving into ductal carcinoma in situ (DCIS) and invasive carcinoma, occurring simultaneously with a benign phyllodes tumor in the same breast. The importance of this case lies in emphasizing the crucial need for surveillance in patients with a long history of fibroadenomas and the necessity to investigate any rapid change in the size of fibroadenoma.
CASE PRESENTATION
A 35-year-old multiparous female with a 17 year history of bilateral multiple breast lumps presented with recent onset of right breast pain and yellowish nipple discharge. Two lumps in her right breast had demonstrated an increase in size. Examination revealed a significant mass in the retroareolar region of the right breast and another at the 2 o'clock position. Histopathological examination of the biopsy specimens revealed fibroadenoma and benign phyllodes tumor. The patient underwent a bilateral breast lumpectomy. Further histopathological examination revealed ductal carcinoma in situ and invasive carcinoma within a complex fibroadenoma in the right breast and benign phyllodes tumor. Sentinel lymph node biopsy was negative. She had adjuvant radiations and trastuzumab. Regular follow-ups show no recurrence.
CLINICAL DISCUSSION
Fibroadenomas are usually benign but rarely undergo malignant change. Quick response to size changes and early detection greatly enhance patient results.
CONCLUSION
Ductal carcinoma in situ and invasive breast cancer, a rare malignancy found within a fibroadenoma, necessitates histopathological specimens and immunohistochemical results for accurate diagnosis. Survival rates are significantly enhanced through a multidisciplinary approach.
PubMed: 38368667
DOI: 10.1016/j.ijscr.2023.109196 -
Cureus May 2024We present the case of a 52-year-old female with a giant phyllodes tumor (GPT), which was fungating through the skin that showed fleshy polypoid outgrowths. Histological...
We present the case of a 52-year-old female with a giant phyllodes tumor (GPT), which was fungating through the skin that showed fleshy polypoid outgrowths. Histological analysis revealed stromal atypia, mitotic activity, and stromal overgrowth; however, the tumor border was well-defined, and malignant heterologous elements were not observed. Therefore, as some but not all malignant histological characteristics were present, we diagnosed the patient with borderline GPT. In cases of phyllodes tumor (PT) with the unique gross findings of fungation through the skin as fleshy polypoid outgrowths, caution is required for the subsequent course because even if the PT is graded as benign histologically, a malignant process can occur. Pathologists should note that the sampling of the collection site and the ambiguity of the histological grading of PT may affect the final diagnosis of GPT. It is also important to perform surgery with adequate preservation of the resected margins to control recurrence for patients with GPT.
PubMed: 38910772
DOI: 10.7759/cureus.61020 -
Diagnostics (Basel, Switzerland) Jul 2023Liposarcoma of the breast is a rare form of cancerous tumor that can be mistaken for primary breast cancer. A recent instance involved a woman who was 54 years old and...
Liposarcoma of the breast is a rare form of cancerous tumor that can be mistaken for primary breast cancer. A recent instance involved a woman who was 54 years old and went in for her annual screening mammogram. The mammogram revealed that she had a 1 cm focal asymmetry of equal density in her right axillary tail, approximately 9 cm from the nipple. After nine months, the patient observed a rapidly growing mass even though the initial ultrasound scan did not detect anything unusual. A targeted mammogram demonstrated a large and dense mass confined to the right axillary tail, followed by an ultrasound scan that revealed a heterogeneous hyperechoic, echogenic mass. Histopathology after surgery showed that the patient had an undifferentiated pleomorphic breast liposarcoma. This diagnosis was reached after the patient underwent surgery.Liposarcoma of the breast is a concerning condition that needs careful management and close monitoring, although it is relatively uncommon. Early detection of the patient's condition and prompt treatment can help improve the patient's prognosis. This can be accomplished by remaining vigilant with routine screenings and following up on any unusual findings or changes in breast tissue. However, it is possible to diagnose this condition as primary breast cancer incorrectly; consequently, healthcare providers need to conduct comprehensive evaluations to ensure diagnostic accuracy and the delivery of appropriate treatment.
PubMed: 37510172
DOI: 10.3390/diagnostics13142428