Successful Treatment of a Locally Recurrent and Metastatic Malignant Phyllodes Tumor with Accelerated Radiotherapy and Nab-Paclitaxel, Cisplatin, and Liposomal Doxorubicin Chemotherapy

Phyllodes tumors are rare breast lesions of fibroepithelial origin. Malignant transformation with metastases is linked with poor prognosis. We present a case of a 62-year-old woman with a recurrent malignant phyllodes tumor of the breast and lung metastases. The patient was originally presented with a borderline phyllodes tumor (7.4 cm) of the left breast, treated with wide local excision. A year later, the patient returned with palpable left breast masses. On PET-CT, increased uptake of <sup>18</sup>F-FDG by large breast tumors was evident. A right lung lesion of metastatic origin was also present. A simple left breast mastectomy was performed. Histopathological report described 2 malignant phyllodes tumors (7 cm and 6.5 cm). One month later, during the CT simulation for radiotherapy planning, encysted fluid in the chest wall and 2 additional pulmonary lesions of the right lung were identified, confirming progressive lung metastatic disease. Both the chest wall and the regional lymph node area were irradiated with hypofractionated and accelerated radiotherapy. Biweekly chemotherapy with albumin-bound paclitaxel, cisplatin, and liposomal doxorubicin was also prescribed at the start of radiotherapy for 12 cycles. At the end of chemotherapy, complete regression of lung metastases was achieved, and there was no evidence of local recurrence. Within 2 years of follow-up, the patient is free of disease and treatment-related toxicities. Accelerated hypofractionated radiotherapy is effective in the locoregional control of malignant phyllodes tumors. The combination of cisplatin with nab-paclitaxel and liposomal doxorubicin chemotherapy has acceptable toxicity and is highly effective in eradicating metastatic lesions.

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

BMC Women s Health ◽

10.1186/s12905-021-01359-5 ◽

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.

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Malignant Phyllodes Tumor by the Example of a Clinical Case

Journal of radiology and nuclear medicine ◽

10.20862/0042-4676-2021-102-3-178-182 ◽

2021 ◽

Vol 102 (3) ◽

pp. 178-182

Author(s):

G. P. Korzhenkova ◽

A. A. Kasymova

Keyword(s):

Breast Cancer ◽

Clinical Case ◽

Phyllodes Tumor ◽

Left Breast ◽

Highly Qualified ◽

Diagnose Breast Cancer ◽

Malignant Phyllodes Tumor ◽

Phyllodes Tumors ◽

Common Cancer ◽

Morphological Diagnosis

Breast cancer is the most common cancer in women worldwide, but there are also rarer types of breast neoplasms in clinical practice. One of these neoplasms is a phyllodes tumor. Due to the rare occurrence of phyllodes tumors and few studies of this pathology, there is today no information about the precise etiology and pathogenesis of this tumor. For the same reasons, it is very difficult to correctly and timely diagnose breast cancer, which requires both a highly qualified radiologist who first detects this disease in a patient and a pathologist who establishes a final morphological diagnosis. Existing studies, such as mammography and ultrasound, do not have reliable criteria for the diagnosis of phyllodes tumors and are unable to differentiate different histological types of these neoplasms, which further complicates the diagnosis of this pathology. Also, standards for the treatment of patients with this diagnosis have not been fully approved. The paper describes a clinical case of successful surgical treatment for a malignant phyllodes tumor of the left breast in a 47-year-old patient.

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Malignant Phyllodes Tumor Including Aneurysmal Bone Cyst-Like Areas in Pregnancy - a Case Report and Review of the Literature

Breast Care ◽

10.1159/000448236 ◽

2016 ◽

Vol 11 (4) ◽

pp. 291-294 ◽

Cited By ~ 1

Author(s):

Canan Kelten ◽

Ceren Boyaci ◽

Cem Leblebici ◽

Kemal Behzatoglu ◽

Didem C. Trabulus ◽

...

Keyword(s):

Case Report ◽

Bone Cyst ◽

Clinical Breast Examination ◽

Phyllodes Tumor ◽

Breast Cancer Diagnosis ◽

Left Breast ◽

Malignant Phyllodes Tumor ◽

Her Family ◽

Simple Mastectomy ◽

Clinical Breast

Background: Malignant phyllodes tumors of the breast are rare biphasic neoplasms. Only few cases related to pregnancy have been reported. Case Report: A 37-year-old woman presented with swelling and pain in her left breast as well as hyperemia on the breast skin, 4 weeks after labor. In her family history, her aunt and maternal cousin had had a breast cancer diagnosis. Clinical evaluation of the patient was consistent with a breast abscess. Therefore, abscess drainage and biopsy from the cavity wall were performed. However, the biopsy was diagnosed as malignant phyllodes tumor. An evaluation by ultrasonography showed a well-defined hypoechoic mass with many cystic spaces covering the entire breast tissue. Therefore, a simple mastectomy was performed. Microscopic examination revealed a high-grade malignant phyllodes tumor. Additionally, bone cyst-like areas in the form of sponge-like blood-filled non-endothelialized spaces were observed. Conclusions: Since the breasts become larger due to the physiological changes during pregnancy, any underlying breast lesions may be obscured. Therefore, clinical breast examination in the first visit of pregnancy is important.

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Granulocyte-colony stimulating factor-producing malignant phyllodes tumor of the breast: a rare case

Surgical Case Reports ◽

10.1186/s40792-021-01113-x ◽

2021 ◽

Vol 7 (1) ◽

Author(s):

Kimihisa Mizoguchi ◽

Kazuhisa Kaneshiro ◽

Makoto Kubo ◽

Yoshihiko Sadakari ◽

Yoshizo Kimura ◽

...

Keyword(s):

Rare Case ◽

Phyllodes Tumor ◽

Left Breast ◽

Lymph Node Biopsy ◽

Granulocyte Colony Stimulating Factor ◽

Colony Stimulating Factor ◽

Malignant Phyllodes Tumor ◽

Csf Levels ◽

Wbc Count ◽

Stimulating Factor

Abstract Background Granulocyte-colony stimulating factor (G-CSF)-producing tumors can cause leukocytosis despite an absence of infection. G-CSF-producing tumors have been reported in various organs such as the lung, esophagus, and stomach but rarely in the breast. We report a case of G-CSF-producing malignant phyllodes tumor of the breast. Case presentation An 84-year-old woman visited our hospital complaining of a lump in her left breast without fever and pain. Laboratory tests revealed elevated white blood cell (WBC) count and G-CSF levels. A malignant tumor of the breast was diagnosed by core needle biopsy. We performed a total mastectomy and sentinel lymph node biopsy. The tumor was identified as a G-CSF-producing malignant phyllodes tumor. Within 7 days after surgery, the patient’s WBC count and G-CSF level had decreased to normal levels. She is alive without recurrence 13 months after surgery. Conclusions We encountered a rare case of G-CSF-producing malignant phyllodes tumor of the breast. PET–CT revealed diffuse accumulation of FDG in the bone. Phyllodes tumors need to be differentiated from bone metastasis, lymphoma, and leukemia. We must be careful to not mistake this type of tumor for bone marrow metastasis.

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Increased CD105 expression is associated with disease progression in phyllodes tumors - A report of a borderline phyllodes tumor with lung metastases and a study of 54 phyllodes tumors

Annals of Diagnostic Pathology ◽

10.1016/j.anndiagpath.2017.04.002 ◽

2018 ◽

Vol 32 ◽

pp. 4-9 ◽

Cited By ~ 2

Author(s):

Kangyu Wang ◽

Qianhua Li ◽

Ranran Shi ◽

Dandan Yang ◽

Wenlu Zou ◽

...

Keyword(s):

Disease Progression ◽

Lung Metastases ◽

Phyllodes Tumor ◽

Phyllodes Tumors

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

Case Reports in Oncological Medicine ◽

10.1155/2020/1989452 ◽

2020 ◽

Vol 2020 ◽

pp. 1-7 ◽

Cited By ~ 1

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.

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

Case Reports in Oncological Medicine ◽

10.1155/2018/6491675 ◽

2018 ◽

Vol 2018 ◽

pp. 1-5 ◽

Cited By ~ 1

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.

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