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Large Malignant Phyllodes Tumor of the Breast with Metastases to the Lungs.

Augustyn A, Sahoo S, Wooldridge RD - Rare Tumors (2015)

Bottom Line: Phyllodes tumors of the breast account for less than 0.5% of breast cancers and present most commonly in women 45 to 49 years old.We report the case of a 56-year-old female who presented with a rapidly enlarging mass in her right breast 18 cm in maximum dimension that completely effaced the breast and distorted the nipple.The patient underwent a successful total mastectomy after core biopsy revealed a diagnosis of phyllodes tumor.

View Article: PubMed Central - PubMed

Affiliation: Hamon Center for Therapeutic Oncology Research, University of Texas Southwestern Medical Center , Dallas, TX, USA ; Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center , Dallas, TX, USA.

ABSTRACT
Phyllodes tumors of the breast account for less than 0.5% of breast cancers and present most commonly in women 45 to 49 years old. The importance in managing fibroepithelial lesions lies in distinguishing fibroadenomas, which are benign, from phyllodes tumors, which can be malignant and require complete surgical excision. We report the case of a 56-year-old female who presented with a rapidly enlarging mass in her right breast 18 cm in maximum dimension that completely effaced the breast and distorted the nipple. The patient underwent a successful total mastectomy after core biopsy revealed a diagnosis of phyllodes tumor. Surgical resection is the primary treatment modality; neoadjuvant and adjuvant therapies remain controversial. Here, we report the case of a large malignant phyllodes tumor metastatic to the lungs, review the literature, and discuss diagnostic modalities and adjunct nonsurgical therapies.

No MeSH data available.


Related in: MedlinePlus

Ultrasound-guided core needle biopsy demonstrating phyllodes tumor with a cellular spindle cell tumor and stromal overgrowth. A) Low magnification of Hematoxylin and Eosin (H&E) stain. B) High magnification of H&E stain. C-E). Histological analysis of surgical specimen. C) Low magnification of H&E stain of the tumor showing variegated stromal cellularity with slit like spaces composed of benign ductal elements. D) Medium magnification of H&E stain showing that the border of the tumor is well-circumscribed. E) High magnification of H&E stain demonstrating hypercellular stroma.
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fig002: Ultrasound-guided core needle biopsy demonstrating phyllodes tumor with a cellular spindle cell tumor and stromal overgrowth. A) Low magnification of Hematoxylin and Eosin (H&E) stain. B) High magnification of H&E stain. C-E). Histological analysis of surgical specimen. C) Low magnification of H&E stain of the tumor showing variegated stromal cellularity with slit like spaces composed of benign ductal elements. D) Medium magnification of H&E stain showing that the border of the tumor is well-circumscribed. E) High magnification of H&E stain demonstrating hypercellular stroma.

Mentions: Ultrasound-guided core needle biopsy identified a phyllodes tumor with areas of ischemic necrosis and focal squamous metaplasia of the ductal epithelium. The stroma was moderately cellular with mild-to-moderate nuclear pleomorphism. The stromal mitoses varied from 5 to 6 per 10 high power fields (Figure 2A,B). As per the current guidelines, the tumor was interpreted as at least a borderline PT.15


Large Malignant Phyllodes Tumor of the Breast with Metastases to the Lungs.

Augustyn A, Sahoo S, Wooldridge RD - Rare Tumors (2015)

Ultrasound-guided core needle biopsy demonstrating phyllodes tumor with a cellular spindle cell tumor and stromal overgrowth. A) Low magnification of Hematoxylin and Eosin (H&E) stain. B) High magnification of H&E stain. C-E). Histological analysis of surgical specimen. C) Low magnification of H&E stain of the tumor showing variegated stromal cellularity with slit like spaces composed of benign ductal elements. D) Medium magnification of H&E stain showing that the border of the tumor is well-circumscribed. E) High magnification of H&E stain demonstrating hypercellular stroma.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4508638&req=5

fig002: Ultrasound-guided core needle biopsy demonstrating phyllodes tumor with a cellular spindle cell tumor and stromal overgrowth. A) Low magnification of Hematoxylin and Eosin (H&E) stain. B) High magnification of H&E stain. C-E). Histological analysis of surgical specimen. C) Low magnification of H&E stain of the tumor showing variegated stromal cellularity with slit like spaces composed of benign ductal elements. D) Medium magnification of H&E stain showing that the border of the tumor is well-circumscribed. E) High magnification of H&E stain demonstrating hypercellular stroma.
Mentions: Ultrasound-guided core needle biopsy identified a phyllodes tumor with areas of ischemic necrosis and focal squamous metaplasia of the ductal epithelium. The stroma was moderately cellular with mild-to-moderate nuclear pleomorphism. The stromal mitoses varied from 5 to 6 per 10 high power fields (Figure 2A,B). As per the current guidelines, the tumor was interpreted as at least a borderline PT.15

Bottom Line: Phyllodes tumors of the breast account for less than 0.5% of breast cancers and present most commonly in women 45 to 49 years old.We report the case of a 56-year-old female who presented with a rapidly enlarging mass in her right breast 18 cm in maximum dimension that completely effaced the breast and distorted the nipple.The patient underwent a successful total mastectomy after core biopsy revealed a diagnosis of phyllodes tumor.

View Article: PubMed Central - PubMed

Affiliation: Hamon Center for Therapeutic Oncology Research, University of Texas Southwestern Medical Center , Dallas, TX, USA ; Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center , Dallas, TX, USA.

ABSTRACT
Phyllodes tumors of the breast account for less than 0.5% of breast cancers and present most commonly in women 45 to 49 years old. The importance in managing fibroepithelial lesions lies in distinguishing fibroadenomas, which are benign, from phyllodes tumors, which can be malignant and require complete surgical excision. We report the case of a 56-year-old female who presented with a rapidly enlarging mass in her right breast 18 cm in maximum dimension that completely effaced the breast and distorted the nipple. The patient underwent a successful total mastectomy after core biopsy revealed a diagnosis of phyllodes tumor. Surgical resection is the primary treatment modality; neoadjuvant and adjuvant therapies remain controversial. Here, we report the case of a large malignant phyllodes tumor metastatic to the lungs, review the literature, and discuss diagnostic modalities and adjunct nonsurgical therapies.

No MeSH data available.


Related in: MedlinePlus