Malignant Phyllodes Tumor with Lipomatous Differentiation: A Unique Presentation

2020 ◽  
Vol 154 (Supplement_1) ◽  
pp. S36-S36
Author(s):  
P Johal ◽  
C Sebastiano
Keyword(s):  
Phyllodes Tumor ◽  
Excisional Biopsy ◽  
Surrounding Tissue ◽  
Beta Catenin ◽  
Significant Past Medical History ◽  
Ki 67 ◽  
Complete Excision ◽  
Malignant Phyllodes Tumor ◽  
Phyllodes Tumors ◽  
Wide Range

Abstract Casestudy Phyllodes tumors (PT) are uncommon biphasic fibroepithelial neoplasms that account for <1% of all breast tumors. The distinction between benign and malignant PTs is made based on a number of histologic characteristics, including an infiltrative margin, stromal overgrowth, mitotic count, hypercellularity and atypia. 30% of cases show heterologous differentiation, which mostly occurs in stromal elements. This can result in a wide range of tumor histopathology including lipomatous areas. Results We present the case of a 46-year-old female with a 3.1 cm left breast palpated mass and no significant past medical history. Ultrasound guided needle biopsy revealed multiple foci of hypercellular spindle cells with marked atypia and mitoses (ki-67: 40–60%) surrounded by focal fat necrosis. Immunohistochemical staining was negative for CK 5/6, p63, CAM 5.2, SMA, desmin, AE1/3, CD163, nuclear beta-catenin and CD34. The patient subsequently underwent a wire localization excisional biopsy. Microscopic examination revealed a biphasic hypercellular lesion with both stromal and distorted glandular elements and extensive lipomatous differentiation. Although mostly well- circumscribed, some infiltration into the surrounding tissue was identified as well as nuclear atypia and an increased mitotic rate (10 mitoses/HPF). The diagnosis of malignant phyllodes tumor with lipomatous differentiation was made based on these findings. FISH was performed and was negative for MDM2, suggesting that the lipomatous component itself was not malignant (i.e. liposarcoma) Conclusion Malignant phyllodes tumors rarely show heterologous differentiation. A literature review revealed that most lipomatous differentiation was liposarcomatous with rare cases of pure lipomatous metaplasia. Although malignant phyllodes tumor have the highest rate of metastasis relative to their benign counterparts, complete excision has resulted in a mortality rate of approximately 12%. The clinical implications of lipomatous differentiation are currently unknown. However, in these cases ensuring the lack of malignant liposarcomatous tumor growth is imperative.

scholarly journals Malignant Phyllodes Tumor in an Adolescent Female: A Rare Case Report and Review of the Literature

2020 ◽  
Vol 2020 ◽  
pp. 1-7 ◽  
Author(s):  
Gabriel S. Makar ◽  
Michael Makar ◽  
Joanna Ghobrial ◽  
Kathryn Bush ◽  
Ryan Allen Gruner ◽  
...  
Keyword(s):  
Breast Neoplasms ◽  
Rare Case ◽  
Phyllodes Tumor ◽  
Adolescent Females ◽  
Small Subset ◽  
Review Of The Literature ◽  
Malignant Phyllodes Tumor ◽  
Phyllodes Tumors ◽  
Rare Case Report

Primary breast neoplasms are rare in adolescent females, most of which are benign. Phyllodes tumors constitute a remarkably small subset of breast neoplasms (0.3-0.9%) with malignant phyllodes tumors being even more uncommon. Malignant phyllodes tumors tend to progress rapidly though only 1.5% metastasize. They are also associated with a higher rate of recurrence than their benign counterparts, underlying the importance of adequate surgical margins. It is therefore imperative to be able to identify these tumors early allowing for prompt resection and close follow-up. Here, we present the rare case of a 17-year-old female presenting with a rapidly enlarging breast mass, which was ultimately found to be a malignant phyllodes tumor. We further performed a review of the literature to highlight only 22 other cases reported in adolescent females.

scholarly journals Malignant Phyllodes Tumor of the Breast with Metastasis to the Pancreas: A Case Report and Review of Literature

2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
R. A. Amir ◽  
Rola S. Rabah ◽  
S. S. Sheikh
Keyword(s):  
Case Report ◽  
Breast Neoplasms ◽  
Distant Metastasis ◽  
Case Reports ◽  
Phyllodes Tumor ◽  
Pancreatic Metastasis ◽  
Rare Tumor ◽  
Review Of Literature ◽  
Malignant Phyllodes Tumor ◽  
Phyllodes Tumors

Phyllodes tumor (PT) is a rare tumor of the breast accounting for approximately 1% of all breast neoplasms. In 1838, J. Muller coined the term “cystosarcoma phyllodes” based on the leaf-like projections of the tumor extending into the cystic spaces and sarcomatous stromal growth. However, seeing as up to 70% of phyllodes tumors are benign, “cystosarcoma” was removed, and the tumor is now recognized simply as phyllodes tumor. It is mainly seen in females between the ages of 35 and 55. Although most phyllodes tumors are benign, malignant cases do uncommonly occur, 22% of which have distant metastasis typically to the lungs and bones. Rarely, this tumor metastasizes to other locations. Herein, we report a case of malignant phyllodes tumor with metastasis to the pancreas. According to our knowledge, only 3 case reports of pancreatic metastasis from malignant phyllodes tumor have been reported in literature thus far. We aim to increase awareness among physicians of this rare metastasic potential of the uncommonly encountered malignant phyllodes tumor.

Malignant phyllodes tumor composed almost exclusively of a fibrosarcomatous component: a case report and review of malignant phyllodes tumors with metastases

Breast Cancer ◽  
2009 ◽  
Vol 17 (3) ◽  
pp. 218-224 ◽  
Author(s):  
Satomi Suzuki-Uematsu ◽  
Kazuko Shiraishi ◽  
Taro Ito ◽  
Naoki Adachi ◽  
Yoshihisa Inage ◽  
...  
Keyword(s):  
Case Report ◽  
Phyllodes Tumor ◽  
Malignant Phyllodes Tumor ◽  
Phyllodes Tumors

scholarly journals Large Malignant Phyllodes Tumor of the Breast: Case Report of a Young Female and Review of Literature

2020 ◽  
pp. 137-146
Author(s):  
Melissa Kyriakos Saad ◽  
Imad El Hajj ◽  
Elias Saikaly
Keyword(s):  
Malignant Tumors ◽  
Pectoralis Major Muscle ◽  
Phyllodes Tumor ◽  
World Health ◽  
Low Grade ◽  
Accurate Identification ◽  
Malignant Phyllodes Tumor ◽  
Phyllodes Tumors ◽  
Post Surgery ◽  
The Right

Background: Phyllodes tumors are rare fibroepithelial neoplasm of the breast, representing 0.3 to 0.5% of all female breast neoplasms. The term ‘‘phyllodes tumor” by the World Health Organization (WHO) categorizes it into benign, borderline, and malignant tumors based on histopathological characteristics. Malignant phyllodes tumor is an uncommon but aggressive breast malignancy and accounts for approximately 25% of all phyllodes tumors.Case Presentation: A 23-year-old female patient Gravida 0 Para 0, previously healthy, with no family history of breast or ovarian cancer was referred to our institution for managing a right breast mass increasing in size over a period of 1 month associated with reddish-brown discoloration of the skin. Breast ultrasound showed an isodense oval mass measuring approximately 16x14x12cm in the right lower outer quadrant of her breast. Core biopsy and FNA done revealed a low grade phyllodes tumor. MRI of breasts showed a huge mass of the right breast occupying all quadrants, measuring 15x14.5 cm in its greatest axis with involvement of the pectoralis major muscle, with no evidence of suspicious axillary lymphadenopathy. Distant metastatic work-up with CT scan of chest abdomen and pelvis and a PET scan did not show distant metastasis. Hence, the patient underwent right total mastectomy with a final pathology compatible with malignant phyllodes tumor. She is on regular follow up and 18 months post-surgery is still disease free.Conclusion: Management of malignant phyllodes tumor remains debatable, especially when it comes to the effect of adjuvant radiotherapy and chemotherapy. From a surgical perspective, whether phyllodes tumors should be considered as epithelial breast cancers or as soft tissue sarcoma is another debate. On the other hand, although challenging, accurate identification of phyllodes tumor initially may aid in decreased recurrence.

scholarly journals Not Every Fat-Containing Lesion on Mammogram is a Benign Finding: Case Report and Review of Breast Malignant Phyllodes Tumor with Heterologous Liposarcomatous Differentiation

2019 ◽  
Vol 9 ◽  
pp. 10
Author(s):  
Neetu Soni ◽  
Nour T Aly ◽  
Aditi Vidholia ◽  
Fabiana Policeni
Keyword(s):  
Case Report ◽  
Phyllodes Tumor ◽  
Imaging Findings ◽  
Malignant Phyllodes Tumor ◽  
Phyllodes Tumors ◽  
Epithelial Component ◽  
Sarcomatous Transformation ◽  
Increased Risk ◽  
Stromal Component ◽  
Proven Case

Phyllodes tumors (PTs) are a rare fibroepithelial tumor of the breast. Histopathological confirmation of stromal and epithelial component is required for making the diagnosis of PT, and stromal component carries an increased risk of sarcomatous transformation. We present imaging findings of a histologically proven case of malignant PT with heterologous liposarcomatous transformation of the breast.

scholarly journals Breast Sarcomas: Rare but Challenging Entity for Diagnosis

2020 ◽  
Vol 7 (12) ◽  
pp. A556-562
Author(s):  
Rashmi Khemani ◽  
Sudha S Murthy ◽  
Naidu C K ◽  
Daphne Fonseca ◽  
Suseela K ◽  
...  
Keyword(s):  
Medical Records ◽  
Phyllodes Tumor ◽  
Metaplastic Carcinoma ◽  
Diagnostic Challenge ◽  
Ki 67 ◽  
Undifferentiated Pleomorphic Sarcoma ◽  
Phyllodes Tumors ◽  
Pleomorphic Sarcoma ◽  
Stromal Sarcoma ◽  
Breast Malignancies

Background: Breast sarcomas are extremely rare, can be primary or secondary, pose a high risk of recurrence with an overall poor prognosis. Primary breast sarcomas constitute < 1% of all primary breast malignancies and less than 5% of all sarcomas. Sarcomas arising in phyllodes tumors account for < 6 % of all phyllodes tumors. The most common subtype of both primary and secondary sarcoma is angiosarcoma. Methods: This was a retrospective study of patients diagnosed as sarcoma of breast (excluding malignant phyllodes and metaplastic carcinoma) during the period from January 2016 to July 2019. The demographic and clinical features were noted from the medical records. The details of gross specimens (grossed in strict accordance with CAP protocols) were noted. The haematoxylin and eosin-stained slides along with immunohistochemistry (IHC) (pan cytokeratin, calponin, vimentin, SMA, CD117, Ki 67, desmin, CD10, CK5/6, EMA, p63, CD34, CD56, myogenin, CD99, p16, S100, BCL2, CD31, caldesmon and CD68) were reviewed and categorized according to WHO (2019) criteria. Result: The median age of patients was fifty years. There were fourteen breast sarcomas including one arising in phyllodes tumor during the study period. These included undifferentiated pleomorphic sarcoma (4), liposarcoma (2), myxofibrosarcoma (2), angiosarcoma (2), one each of leiomyosarcoma, rhabdomyosarcoma, fibrosarcoma and stromal sarcoma. Despite using a wide panel of IHC markers, 4/14 (28.57%) sarcomas were classified as undifferentiated pleomorphic sarcoma. Conclusion: Primary breast sarcomas are rare tumors and pose diagnostic challenge. It is important to categorize these entities in view of the differing biologic behavior and molecular profiles. Morphology along with IHC is important for diagnosis, treatment and prognosis.

Phyllodes tumor of breast, real-world data from a referral center in Mexico.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e19356-e19356
Author(s):  
María Inés Contreras-Salcido ◽  
Carlos Eduardo Salazar-Mejía ◽  
Adriana González-Gutiérrez ◽  
Rolando Jacob Martinez ◽  
Jackeline Grace Lara-Campos ◽  
...  
Keyword(s):  
Radical Mastectomy ◽  
Phyllodes Tumor ◽  
Breast Disease ◽  
Breast Conserving Surgery ◽  
Real World Data ◽  
Referral Center ◽  
Phyllodes Tumors ◽  
Wide Range ◽  
Simple Mastectomy ◽  
Mixed Histology

e19356 Background: Phyllodes tumors of breast (PTB) comprise a wide range of rare fibroepithelial neoplasms representing less than 1% of all breast tumors. Studies that describe the clinical characteristics of Mexican women with PTB are scarce. Methods: We performed a retrospective analysis of all patients with newly diagnosed PTB treated at an oncology referral center in Northeast Mexico from 2013 to 2018. Results: Twenty-three women were included in the analysis. Median age at diagnosis was 51 years. Diagnosis was made by self-detection in all cases, with a median tumor size of 12.8 cm. Approximately 26% of patients had a history of benign breast disease. Regarding treatment received 39% underwent radical mastectomy whereas simple mastectomy and breast-conserving surgery were performed in 39 and 22%, respectively. PTB were classified as benign, borderline, and malignant in 17, 13, and 70% of cases, respectively. Patients with malignant PTB showed a heterologous component in 22% of cases (60% with mixed histology, 20% fibromyxosarcoma, and 20% osteosarcoma). Metastatic disease at diagnosis was documented in 3 patients. Relapse of disease was confirmed in eight patients, two of them corresponded with borderline histology and six to malignant subtype. Recurrence sites by frequency were locoregional only 38%; distant disease to the lungs only 12%; and combined metastases to lung, liver and central nervous system 50%. Regarding management of recurrence, four patients received chemotherapy, two received only radiotherapy, one was treated with radiotherapy and chemotherapy and one woman received surgical treatment with adjuvant radiotherapy. Among all patients analyzed, the median overall survival was 23.6 months. Conclusions: To our knowledge, this is one of the first studies analyzing the clinical-pathological characteristics of phyllodes tumors in the Mexican population.

scholarly journals Effective Treatment of a Malignant Breast Phyllodes Tumor with Doxorubicin-Ifosfamide Therapy

2019 ◽  
Vol 2019 ◽  
pp. 1-5
Author(s):  
Shinya Yamamoto ◽  
Shigeru Yamagishi ◽  
Toshiro Kohno ◽  
Ryosuke Tajiri ◽  
Toshikazu Gondo ◽  
...  
Keyword(s):  
Pleural Effusion ◽  
Left Lung ◽  
Phyllodes Tumor ◽  
Lung Mass ◽  
Malignant Phyllodes Tumor ◽  
Phyllodes Tumors ◽  
Malignant Breast ◽  
One Year ◽  
The Right ◽  
Chemotherapy Strategy

Malignant phyllodes tumors of the breast occur infrequently and are difficult to treat with chemotherapy. Here, we present an effective chemotherapy strategy for recurrent malignant breast phyllodes tumors. A 48-year-old woman was diagnosed with a malignant phyllodes tumor in her right breast and underwent total right mastectomy. One year later, the tumor recurred in the right (a 2.2 cm mass) and left (a 10 cm mass) lungs; pleural effusion was also observed in the left lung. Eight courses of doxorubicin-ifosfamide (AI) therapy were administered. After treatment, the right lung mass and pleural effusion regressed completely and the left lung mass regressed to 2 cm. In conclusion, AI therapy is useful for treating recurrent malignant breast phyllodes tumors.

scholarly journals Advance Malignant Phyllodes Tumor with Active Bleeding in Children: A Rare Case

2021 ◽  
Vol 15 (4) ◽  
pp. 208
Author(s):  
Dedy Hermansyah ◽  
Fernando Silalahi ◽  
Albiner Simarmata ◽  
Denny Rifsal Siregar
Keyword(s):  
Physical Examination ◽  
Rare Case ◽  
Phyllodes Tumor ◽  
Active Bleeding ◽  
Breast Lesions ◽  
Malignant Phyllodes Tumor ◽  
Phyllodes Tumors ◽  
Prompt Treatment ◽  
The Right ◽  
Current Guidelines

Introduction: Phyllodes tumors are fibroepithelial breast lesions that are uncommon in women and rare among children. Due to scarcity, there are only a few large pediatric phyllodes tumor series. Current guidelines do not differentiate treatment recommendations between children and adults.Case Presentation: A 12-year-old girl presented with a lump in her right breast which grew rapidly within a month. On physical examination, we found a mass on the right breast sized ± 10 x 10 cm; the lump was fragile and bled easily. The patient’s condition was getting worse and worse. Due to this deterioration, we performed a mastectomy immediately.Conclusions: The incidence of malignant phyllodes tumor in children is very rare and required prompt treatment in emergency cases.

scholarly journals Apatinib treatment is effective for metastatic malignant phyllodes tumors of the breast: a case report

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xiaolu Wang ◽  
Li Xie ◽  
Wenjing Hu ◽  
Jing Yan ◽  
Xiaoping Qian ◽  
...  
Keyword(s):  
Partial Response ◽  
Lung Metastases ◽  
Lung Nodule ◽  
Pelvic Mass ◽  
Phyllodes Tumor ◽  
Leg Pain ◽  
Therapeutic Effects ◽  
Palpable Mass ◽  
Malignant Phyllodes Tumor ◽  
Phyllodes Tumors

Abstract Background We report a rare case of malignant phyllodes tumors (MPT) with partial response to apatinib. Case presentation A 26-year-old woman had a palpable mass in her right breast for over a year. After resection, pathology indicated malignant phyllodes tumor. Eleven months after surgery, she underwent reoperation for a lung nodule, which demonstrated lung metastasis. She refused chemotherapy and was rehospitalized six months later due to leg pain. Pelvic mass biopsy revealed metastatic malignant phyllodes tumor. After concurrent chemoradiotherapy of the pelvic mass, multiple lung metastases emerged. Subsequent treatment with apatinib 500 mg/day resulted in a reduction in mass size and partial response. She survived for more than 8 months. Conclusion The present case showed the potential therapeutic effects of apatinib in patients with MPT.

Sign in / Sign up

Export Citation Format

Share Document