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Journal of Pediatric and Adolescent... Feb 2024Malignant phyllodes tumor (MPT) is a rare breast disease that is extremely rare in children. A few cases of pediatric malignant phyllodes tumors have been reported,...
BACKGROUND
Malignant phyllodes tumor (MPT) is a rare breast disease that is extremely rare in children. A few cases of pediatric malignant phyllodes tumors have been reported, including some with a poor prognosis.
CASE
A 14-year-old girl presented with a growing lump on her right breast. On the basis of imaging tests and a core needle biopsy, MPT was diagnosed, and right mastectomy was performed. The postoperative course was uneventful.
SUMMARY AND CONCLUSION
MPT is an infrequent disease in adult females and is extremely rare in pubertal females. It occasionally shows rapid growth, metastasis, and recurrence with a poor prognosis. Early surgical resection is necessary to obtain a cure. When a rapidly growing breast tumor is observed in pubertal females, MPT should be considered.
Topics: Adult; Female; Humans; Child; Adolescent; Phyllodes Tumor; Mastectomy; Breast Neoplasms; Breast; Neoplasm Recurrence, Local
PubMed: 37543241
DOI: 10.1016/j.jpag.2023.07.011 -
Korean Journal of Ophthalmology : KJO Feb 2020
Topics: Adolescent; Breast Neoplasms; Female; Humans; Lacrimal Apparatus Diseases; Nasolacrimal Duct; Neoplasm Metastasis; Phyllodes Tumor
PubMed: 32037753
DOI: 10.3341/kjo.2019.0077 -
F1000Research 2022Cardiac metastases are rare. Herein, we report a case of a 37-year-old female patient with a history of borderline breast phyllodes tumor (PT) treated by surgery,...
Cardiac metastases are rare. Herein, we report a case of a 37-year-old female patient with a history of borderline breast phyllodes tumor (PT) treated by surgery, admitted to our department for concomitant cardiac and pulmonary metastases of malignant PT. Cardiac metastasis occurred through direct extension from pulmonary metastasis to the left atrium via the right inferior pulmonary vein, causing severe mitral valve obstruction. Although the total surgical removal of metastases, the patient had a huge relapse of the mediastinal metastasis resulting in her death.
Topics: Adult; Breast Neoplasms; Female; Heart Neoplasms; Humans; Lung Neoplasms; Mitral Valve; Neoplasm Recurrence, Local; Phyllodes Tumor
PubMed: 35967976
DOI: 10.12688/f1000research.110022.2 -
Canadian Journal of Surgery. Journal... Feb 2019Phyllodes breast tumours are fairly uncommon, and they can be benign, borderline or malignant. General surgeons usually encounter them following the surgical excision of... (Review)
Review
Phyllodes breast tumours are fairly uncommon, and they can be benign, borderline or malignant. General surgeons usually encounter them following the surgical excision of a breast lump that had the appearance of a fibroepithelial lesion. The surgeon is then faced with the question of what to do to establish an acceptable treatment margin. In this discussion, we recommend a plan for the management of Phyllodes tumours based on a review of the recent literature, confirmed by a retrospective review of the results from our centre. A negative margin is acceptable treatment following a lumpectomy for Phyllodes tumours. Only patients with a positive margin should undergo a revision.
Topics: Adult; Breast Neoplasms; Cohort Studies; Female; Humans; Margins of Excision; Mastectomy, Segmental; Middle Aged; Neoplasm Recurrence, Local; Phyllodes Tumor; Prognosis; Rare Diseases; Retrospective Studies; Risk Assessment; Treatment Outcome
PubMed: 30694037
DOI: 10.1503/cjs.005718 -
Oncology Research and Treatment 2024Phyllodes tumors belong to uncommon fibroepithelial breast tumors with a range of biological behaviors. Phyllodes tumors are responsible for less than 1 percent of all... (Review)
Review
INTRODUCTION
Phyllodes tumors belong to uncommon fibroepithelial breast tumors with a range of biological behaviors. Phyllodes tumors are responsible for less than 1 percent of all neoplasms of the breast.
CASE PRESENTATION
A 66-year-old woman presented to our Breastcancer Unit in March 2021 because of a huge mass of her left breast with bleeding out of a tumor necrosis. Five years ago in 2016, a benign phyllodes tumor was diagnosed externally. When we started the treatment, the tumor had a weight of 18.6 kg.
CONCLUSION
We describe the surgical management and the systemic treatment of metastatic disease.
Topics: Female; Humans; Aged; Phyllodes Tumor; Mastectomy; Breast Neoplasms
PubMed: 38382477
DOI: 10.1159/000537956 -
International Journal of Surgical... Aug 2023A 54-year-old woman who incidentally noticed a "knot" in her left breast subsequently underwent excisional biopsy which yielded a diagnosis of malignant neoplasm with...
A 54-year-old woman who incidentally noticed a "knot" in her left breast subsequently underwent excisional biopsy which yielded a diagnosis of malignant neoplasm with sarcomatous features. Given the broad differential diagnosis and imaging findings, the patient underwent bilateral mastectomy and intraoperative sentinel lymph node assessment. An 8.5 cm tumor that was further classified as a malignant phyllodes tumor was identified in the left breast, while the frozen section interpretation came back as positive for metastatic disease which resulted in left axillary lymphadenectomy. Two months later the patient progressed to distant metastatic disease and unfortunately passed away within 6 months after her initial diagnosis. Lymph node metastasis in phyllodes tumor is an exceptionally rare event for which patients usually do not undergo intraoperative sentinel lymph node examination; however high clinical suspicion of metastatic disease would be evidence for further investigation.
Topics: Female; Humans; Middle Aged; Mastectomy; Phyllodes Tumor; Breast Neoplasms; Lymph Nodes; Lymph Node Excision; Sentinel Lymph Node Biopsy; Axilla
PubMed: 36285397
DOI: 10.1177/10668969221125791 -
Japanese Journal of Clinical Oncology Oct 2007The local recurrence rate of phyllodes tumors is high and ensuring a sufficient surgical margin is considered important for local control. However, the preoperative...
Phyllodes tumor of the breast: stromal overgrowth and histological classification are useful prognosis-predictive factors for local recurrence in patients with a positive surgical margin.
BACKGROUND
The local recurrence rate of phyllodes tumors is high and ensuring a sufficient surgical margin is considered important for local control. However, the preoperative diagnosis rate of phyllodes tumors is low and we often encounter cases in which a sufficient surgical margin is not achieved, since in routine medical practice the lesion may not be diagnosed as phyllodes tumor until postoperative biopsy of a mammary mass. Furthermore, there are no established therapeutic guidelines for surgical stump-positive phyllodes tumors. We reviewed the outcomes of excision of phyllodes tumors to investigate factors involved in local recurrence and to determine the indication for re-excision in stump-positive cases.
METHODS
The subjects were 45 patients treated for phyllodes tumors at our institution from January 1980 to July 2005. Age, tumor size, surgical method, stromal cellular atypia, mitotic activity, stromal overgrowth, histological classification and surgical stump status were analyzed.
RESULTS
Median age was 45 years old (range 28-75) and tumor size was 1-17 cm (median 3.5 cm). Pathologic diagnoses were benign, borderline and malignant in 31, five and nine cases, respectively, and the surgical stump was negative in 27 lesions and positive in 15. Median follow-up was 101 months (range 1-273), with local recurrence in six cases and distant metastasis in one. The local recurrence-free rate was 88, 88 and 84% and the disease-free rate was 85, 85 and 81% after 5, 10 and 15 years, respectively. Overall 10-year survival was 97%. In univariate analysis, a positive surgical margin, stromal overgrowth and histological classification were predictive factors for local recurrence after breast-conservation surgery (P = 0.0034, 0.0003, 0.026). A positive surgical stump was the only independent predictor of local recurrence in multivariate analysis (RR 0.086; 95% CI 0.01-0.743, P = 0.012). Stromal overgrowth was a predictive factor for local recurrence in cases with a positive surgical margin (P = 0.0139).
CONCLUSION
Wide excision is the preferred therapy for phyllodes tumor and preoperative diagnosis is important for good local control. Re-excision is recommended in cases with a positive surgical margin and stromal overgrowth and malignancy.
Topics: Adult; Aged; Breast Neoplasms; Disease-Free Survival; Female; Follow-Up Studies; Humans; Middle Aged; Multivariate Analysis; Neoplasm Recurrence, Local; Phyllodes Tumor; Prognosis; Survival Rate
PubMed: 17932112
DOI: 10.1093/jjco/hym099 -
Ginecologia Y Obstetricia de Mexico Dec 2009Phyllodes tumor represents one of the fibroepithelial breast neoplasms that accounts for 0.3% to 1% of the breast tumors.
BACKGROUND
Phyllodes tumor represents one of the fibroepithelial breast neoplasms that accounts for 0.3% to 1% of the breast tumors.
OBJECTIVE
To describe a case series of patients with phyllodes tumor diagnosis.
MATERIAL AND METHODS
We retrospectively reviewed the medical records of patients that had confirmed histological phyllodes tumor collected over a period of ten years.
RESULTS
The incidence was 0.8%, 12.5% of cases corresponded to malignant phyllodes. The average age was 35 years (range 14-50 years); the most frequent site of localization was the superior and external quadrant of the breast; the average tumoral size by image studies (ultrasound or mastography) and by direct measurement was 61 mm (13-150 mm) and 77 mm (30-300 mm), respectively. One case coexisted with pregnancy.
CONCLUSIONS
It is a rare neoplasm, andthe clinician must be aware of its timely diagnosis and treatment, if not some cases will develop breast deformity and some others will be borderline or malignant.
Topics: Adolescent; Adult; Breast Neoplasms; Female; Humans; Middle Aged; Phyllodes Tumor; Retrospective Studies; Young Adult
PubMed: 20077881
DOI: No ID Found -
ANZ Journal of Surgery Dec 2017In screening, the distinction between phyllodes tumour (PT) and fibroadenoma (FA) is imprecise, often needing surgery. (Comparative Study)
Comparative Study Review
BACKGROUND
In screening, the distinction between phyllodes tumour (PT) and fibroadenoma (FA) is imprecise, often needing surgery.
METHODS
In this retrospective cohort study and literature review, we wished to (i) present our experience with PT diagnosed among screening participants; (ii) identify discriminating features between FA and PT; (iii) assess the efficacy of cancer screening in identifying PT; and (iv) for women diagnosed with PT, determine appropriate breast cancer screening schedules.
RESULTS
During a 23.7 years time frame, PT was diagnosed in 30 women, reflecting an incidence of 2.53 per 100 000 women screened. Only 22 (73.3%) PT were found by screening. The remaining eight (26.7%) presented as interval tumours. Thirteen PT were benign, eight borderline and nine malignant. Six of eight (75%) malignant PT were symptomatic. A circumscribed mass, mean diameter 34.7 mm, was the dominant finding. Enlargement (14 imaging, seven clinical) was documented in 21 (70%) cases. Diagnostic open biopsy was required in 67.9%. Follow-up of at least 12 months is available in 20 cases. Only two developed recurrence. One woman died of metastatic PT and one PT recurred locally.
CONCLUSION
The extreme rarity of PT in screening contrasts with the prevalence of FAs. The peak incidence of PT in women is 40-50, whereas screening is targeted at women 50-74. Two yearly screening mammography is not designed to detect PT reliably. In particular, malignant PT grows rapidly and becomes symptomatic. Women with benign PT can continue with screening. Women with borderline and malignant PT should resume screening after 5 years of specialist surveillance.
Topics: Aged; Breast Neoplasms; Early Detection of Cancer; Female; Fibroadenoma; Follow-Up Studies; Humans; Incidence; Mammography; Middle Aged; Phyllodes Tumor; Prevalence; Retrospective Studies
PubMed: 25786884
DOI: 10.1111/ans.13056 -
International Journal of Surgical... Aug 2023Classification of phyllodes tumors is challenging due unclear diagnostic criteria, recently addressed by consensus review criteria. Herein, we reviewed all malignant... (Review)
Review
Classification of phyllodes tumors is challenging due unclear diagnostic criteria, recently addressed by consensus review criteria. Herein, we reviewed all malignant phyllodes tumor resections and reclassified them based on the consensus guidelines, correlating with outcome. We hypothesize that application of criteria would result in a significant proportion being "down-graded" to either borderline or benign phyllodes tumor. Primary resections of malignant phyllodes tumor were reviewed by four AP board-certified, breast fellowship-trained pathologists. Morphologic variables delineated in consensus guidelines (ie stromal cellularity, cellular atypia, tumor border, presence of heterologous elements, presence of stromal overgrowth) were evaluated. Following review, cases were reclassified as benign, borderline, or malignant. Upon reclassification, 20% (5/20) cases were "down-graded" to borderline phyllodes tumor while 80% (15/20) remained malignant phyllodes tumor. Two morphologic features were statistically significant including broadly infiltrating tumor border in 80% (12/15) of malignant phyllodes tumors compared to none in borderline phyllodes tumor (0/5) ( 0.004) and stromal overgrowth in 67% (10/15) of malignant phyllodes tumor compared to none in borderline phyllodes tumors (0/5) ( 0.03). Upon review of the pathology reports, 30% (6/20) contained all 5 histomorphologic variables delineated in the consensus review criteria. Malignant phyllodes tumor resulted in five cases with recurrence (33.3%, 5/15) and three cases with metastases (20.0%, 3/15) and borderline phyllodes tumor resulted in one case with recurrence (20.0%, 1/5) and no metastases (0/5). The consensus guidelines for phyllodes tumor are useful for subclassification. We hypothesize that standardize reporting of the histomorphologic variables may lead to better consensus.
Topics: Humans; Female; Phyllodes Tumor; Stromal Cells; Breast; Pathologists; Breast Neoplasms; Neoplasm Recurrence, Local
PubMed: 35786083
DOI: 10.1177/10668969221106105