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Rozhledy V Chirurgii : Mesicnik... 2021Phyllodes tumors of the breast are rare and very distinct types of mammary neoplasms. They are characterized by their biphasicity, i.e. the presence of stromal and...
INTRODUCTION
Phyllodes tumors of the breast are rare and very distinct types of mammary neoplasms. They are characterized by their biphasicity, i.e. the presence of stromal and epithelial components at the same time. Malignancy is determined by the degree of stromal differentiation. The coexistence of the malignant epithelial component is a very rare phenomenon. Dozens of cases of simultaneous phyllodes tumor and epithelial malignancy have been reported so far. Nevertheless, the biological nature of this process is still an unexplained and a controversial topic.
CASE REPORT
In this paper, we present a case of a patient with a suddenly enlarging lesion in the breast. According to the first surgical resection, a diagnosis of high-grade malignant phyllodes tumor was made with fibrosarcoma differentiation, stromal overgrowth and suppression of the epithelial component. Examination of scar resistence in early postoperative period revealed a triple-negative invasive low-differentiated breast carcinoma with very high proliferative activity, thus malignization of the epithelial component of the tumor occurred. Shortly, a diagnosis of second recurrence was made, treatment included axillary lymph node dissection (ALND) with a negative histological findings. The patient underwent complex adjuvant chemotherapy and radiotherapy and remained disease free 3 years after the surgery.
CONCLUSION
Coexistence of phyllodes tumor and the breast carcinoma is very rare. The article describes the first published case, which documents the subsequent development of invasive low-differentiated ductal carcinoma immediately after resection of high-grade phyllodes tumor. Treatment and prognosis are generally determined by the characteristics of the carcinomatous component.
Topics: Breast; Breast Neoplasms; Carcinoma, Ductal; Female; Humans; Neoplasm Recurrence, Local; Phyllodes Tumor
PubMed: 34465119
DOI: 10.33699/PIS.2021.100.6.295-301 -
The Breast Journal Jul 2017
Topics: Adult; Diagnosis, Differential; Female; Humans; Phyllodes Tumor; Postpartum Period; Vulvar Neoplasms
PubMed: 28224691
DOI: 10.1111/tbj.12767 -
Asian Journal of Surgery Dec 2022
Topics: Humans; Female; Phyllodes Tumor; Breast; Breast Neoplasms
PubMed: 35810113
DOI: 10.1016/j.asjsur.2022.06.094 -
Advances in Experimental Medicine and... 2021Phyllodes tumors of breast (PTB) have been known to an uncommon and particular disease to handle owing to diagnostic ambiguity and unpredictable clinical outcome....
Phyllodes tumors of breast (PTB) have been known to an uncommon and particular disease to handle owing to diagnostic ambiguity and unpredictable clinical outcome. Malignant phyllodes tumors (MPT) are diagnosed when there are marked stromal hypercellularity, atypia, increased mitoses of ≥10/10 HPFs, permeative tumor borders, and stromal overgrowth. The presence of a malignant heterologous element (MHE) places the tumor into the malignant category regardless of other histological features. Excision with negative margins should be achieved for recurrent and malignant phyllodes tumor. An ideal margin width remains to be determined, and may need to be considered in relation to factors such as tumor size and cosmesis. Without the convincing evidence of survival benefit, adjuvant RT has revealed more favorable local control rate compared with observation group. Stromal expression of Twist and Foxc2, epithelial-mesenchymal transition marker, was associated with high tumor grade and poor prognosis. Tumor-associated macrophage drives myoblast differentiation and malignant progression of PTB through a CCL18-driven signaling cascade amenable to antibody disruption. Recent targeted sequencing on PTBs provided insights into the molecular pathogenesis and genetic characterization with potential clinical implications.
Topics: Breast Neoplasms; Cell Differentiation; Epithelial-Mesenchymal Transition; Humans; Neoplasm Recurrence, Local; Phyllodes Tumor
PubMed: 33983602
DOI: 10.1007/978-981-32-9620-6_32 -
International Journal of Gynecological... Mar 2011We present a hitherto unreported case of vulvar phyllodes tumor which displayed morphologically malignant stroma including rhabdomyosarcomatous cellular elements.... (Review)
Review
We present a hitherto unreported case of vulvar phyllodes tumor which displayed morphologically malignant stroma including rhabdomyosarcomatous cellular elements. Clinically, the 61-year-old patient is free of recurrence 1 year after wide local excision.
Topics: Female; Humans; Phyllodes Tumor; Vulvar Neoplasms
PubMed: 21293278
DOI: 10.1097/PGP.0b013e3181f45f58 -
Romanian Journal of Morphology and... 2015Phyllodes tumors are rare breast tumors, accounting for less than 1% of all primary tumors of the breast. Histologically, phyllodes tumors can be divided into benign...
Phyllodes tumors are rare breast tumors, accounting for less than 1% of all primary tumors of the breast. Histologically, phyllodes tumors can be divided into benign (60%), borderline (20%) and malignant (20%). The mammography examination was performed by means of a digital mammography system Giotto 3D Images; the ultrasound examination was performed through a GE Logiq P6 device and histological confirmation was possible after surgery or following the histological biopsy. We grouped the nine patients who presented clinically palpable nodules into two groups, namely: the six patients presenting histological benign results into Group I, and Group II where we included those with borderline and malignant histological results. Mammography performed in 77.7% revealed a well-circumscribed round or oval opacity or with contour lobules. Ultrasound examination was performed in all patients. Mammography and ultrasound have limitation in differentiating between benign lesion and phyllodes tumor. In the nine analyzed cases, mammographic and ultrasound examinations did not allow the differentiation into the three groups of phyllodes tumor. Histopathological examination is considered the golden standard for their diagnosis. Correlations between mammographic and microscopic aspects were inconclusive for determining the degree of differentiation, ultrasound changes could be correlated with the histopathological aspects.
Topics: Adult; Aged; Breast Neoplasms; Diagnostic Imaging; Epithelial Cells; Female; Humans; Hyperplasia; Middle Aged; Phyllodes Tumor; Ultrasonography, Mammary; Young Adult
PubMed: 26743286
DOI: No ID Found -
International Journal of Surgical... Jun 2022Phyllodes tumors of the breast are uncommon, and 6.2% of phyllodes tumors behave in a malignant fashion. The metastatic spread of malignant phyllodes tumor is mainly...
Phyllodes tumors of the breast are uncommon, and 6.2% of phyllodes tumors behave in a malignant fashion. The metastatic spread of malignant phyllodes tumor is mainly hematogenous to lung and bone, and malignant phyllodes tumor metastasizing to the ovary is rare, with only 2 cases reported. We report the third case of metastatic malignant phyllodes tumor to the ovary with a focus on the differential diagnosis of ovarian cancer.
Topics: Breast; Breast Neoplasms; Female; Humans; Ovarian Neoplasms; Phyllodes Tumor
PubMed: 34761702
DOI: 10.1177/10668969211056912 -
The Pan African Medical Journal 2016Phyllodes tumors of the breast are very rare and are exceptional in children and adolescents; their treatment is based on surgery and radiotherapy, with a good... (Review)
Review
Phyllodes tumors of the breast are very rare and are exceptional in children and adolescents; their treatment is based on surgery and radiotherapy, with a good prognosis. We report the case of a 12-year old teenage girl presenting with a mass in the left breast. The diagnosis of a phyllodes tumor was confirmed on the basis of clinical, imaging and histological examinations. Treatment consisted of a large tumorectomy without adjuvant therapy, with good evolution during a 2-year follow-up.
Topics: Breast Neoplasms; Child; Female; Follow-Up Studies; Humans; Mastectomy, Segmental; Phyllodes Tumor; Prognosis; Treatment Outcome
PubMed: 28154712
DOI: 10.11604/pamj.2016.25.20.10219 -
Breast Cancer (Tokyo, Japan) 2010Phyllodes tumor is an uncommon biphasic breast tumor, with the ability to recur and metastasize, and it behaves biologically like a stromal neoplasm. Traditionally,...
Phyllodes tumor is an uncommon biphasic breast tumor, with the ability to recur and metastasize, and it behaves biologically like a stromal neoplasm. Traditionally, phyllodes tumors are graded by the use of a set of histologic data into benign, borderline, and malignant. In most series, all phyllodes tumors may recur, but only the borderline and malignant phyllodes tumors metastasize. On the basis of histologic features, prediction of behavior is difficult. The expression of many biological markers, including p53, hormone receptors, proliferation markers, angiogenesis group of markers, c-kit, CD10 and epidermal growth factor receptor have been explored, and many have been shown to be variably expressed, depending on the grade of the tumor. These markers are, however, of limited value in predicting the behavior of the tumor. Recently investigators have reported a plethora of genetic changes in phyllodes tumors, the most consistent of which seems to be 1q gain by comparative genomic hybridization. Some candidate genes have been mapped to various sites, and preliminary data suggest that some of these changes may be related to recurrence. It is foreseeable that more exciting data will be generated to help us to understand the etiology and pathogenesis of phyllodes tumor.
Topics: Biomarkers, Tumor; Breast Neoplasms; Female; Humans; Neoplasm Staging; Phyllodes Tumor; Prognosis
PubMed: 19434472
DOI: 10.1007/s12282-009-0114-z -
Investigacion Clinica 1993The present study compares the biological behavior of a phyllode tumors to its histological characteristics. Traditional concepts are still valid since 100% of the... (Review)
Review
The present study compares the biological behavior of a phyllode tumors to its histological characteristics. Traditional concepts are still valid since 100% of the tumors with severe atipicity recurred, while 76.9% of those with minimal atipicity did not. In certain cases, histological details provided the explanation for the evolution of the tumor. On those recurs cases with minimal atipicity 66.6% were treated with conservative surgery, probably with insufficient removal of healthy tissue to ensure that no tumor was left. No histological explanation was found for the rest of recurrences. However, they could be caused by the tendency of the tumor to grow with the same histological elements in multiple areas of the same or the opposite mammary gland. As previously demonstrated by other authors, the prognostic importance of the search for other histological features, such as number of mitosis, microscopical margins of the tumor, stromal overgrowing, necrosis, appearance of the epithelial component and the area with the most cellularity. It is suggested that all these features should be determined in each case of the phyllodes tumor.
Topics: Breast Neoplasms; Humans; Hyperplasia; Mitotic Index; Necrosis; Neoplasm Metastasis; Neoplasm Recurrence, Local; Neoplasms, Second Primary; Phyllodes Tumor; Prognosis
PubMed: 8003536
DOI: No ID Found