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Transformation of benign fibroadenoma to malignant phyllodes tumor.

Sanders LM, Daigle ME, Tortora M, Panasiti R - Acta Radiol Open (2015)

Bottom Line: The transformation of a benign fibroadenoma into a phyllodes tumor is uncommon and unpredictable.We present ultrasound and magnetic resonance images, as well as pathology slides from core biopsy and surgical excision, to illustrate this transformation.However, in this case, pathology supports correct initial diagnosis of fibroadenoma and demonstrates a portion of the original fibroadenoma along the periphery of the malignant phyllodes tumor.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Breast Center, Barnabas Health Care Systems, Livingston, NJ, USA.

ABSTRACT
The transformation of a benign fibroadenoma into a phyllodes tumor is uncommon and unpredictable. We report the case of a 40-year-old woman with a core biopsy proven fibroadenoma that underwent transformation into a malignant phyllodes tumor after 3 years of size stability. We present ultrasound and magnetic resonance images, as well as pathology slides from core biopsy and surgical excision, to illustrate this transformation. It has been suggested that phyllodes tumors may be misdiagnosed as fibroadenomas by core biopsy. However, in this case, pathology supports correct initial diagnosis of fibroadenoma and demonstrates a portion of the original fibroadenoma along the periphery of the malignant phyllodes tumor.

No MeSH data available.


Related in: MedlinePlus

(a) A 40-year-old woman. US image at the time of initial core biopsy demonstrates a 1.8 cm well-circumscribed, hypoechoic lesion, consistent with a fibroadenoma. (b) Three years later, the FA is stable in size, but shows slight heterogeneity and is not as well circumscribed. (c) Fat-suppressed dynamic-enhanced MR image performed at the time of second ultrasound shows a 1.8 cm well-circumscribed, enhancing nodule. (d) Fat-suppressed dynamic-enhanced MR image 1 year after the previous MRI shows a heterogeneously enhancing mass that has doubled in size. (e) Left CC mammogram at the time of diagnosis of malignant phyllodes tumor shows a dominant mass with biopsy marker clip. Other marker clips are present in additional previously biopsied stable fibroadenomas.
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fig1-2058460115592061: (a) A 40-year-old woman. US image at the time of initial core biopsy demonstrates a 1.8 cm well-circumscribed, hypoechoic lesion, consistent with a fibroadenoma. (b) Three years later, the FA is stable in size, but shows slight heterogeneity and is not as well circumscribed. (c) Fat-suppressed dynamic-enhanced MR image performed at the time of second ultrasound shows a 1.8 cm well-circumscribed, enhancing nodule. (d) Fat-suppressed dynamic-enhanced MR image 1 year after the previous MRI shows a heterogeneously enhancing mass that has doubled in size. (e) Left CC mammogram at the time of diagnosis of malignant phyllodes tumor shows a dominant mass with biopsy marker clip. Other marker clips are present in additional previously biopsied stable fibroadenomas.

Mentions: A 40-year-old woman with a history of prior biopsy of a benign fibroadenoma (FA) presented for routine screening mammogram and breast ultrasound. On screening ultrasound, a new 1.8 cm hypoechoic lesion was visualized in the lateral left breast (Fig. 1a). Subsequent ultrasound-guided biopsy revealed another benign FA. This FA remained stable in size and appearance both mammographically and sonographically over the next 3 years (Fig. 1b). Breast MRI (performed on Philipps Achieve 1.5 T magnet, with T1, T2 sequences, fat suppressed dynamic sequences following i.v. gadolinium by patient weight) ordered for high-risk screening within this 3-year time interval demonstrated a 1.8 cm well-circumscribed, mostly T2 hyperintense, enhancing lesion containing a biopsy clip in the lateral left breast (Fig. 1c).Fig. 1.


Transformation of benign fibroadenoma to malignant phyllodes tumor.

Sanders LM, Daigle ME, Tortora M, Panasiti R - Acta Radiol Open (2015)

(a) A 40-year-old woman. US image at the time of initial core biopsy demonstrates a 1.8 cm well-circumscribed, hypoechoic lesion, consistent with a fibroadenoma. (b) Three years later, the FA is stable in size, but shows slight heterogeneity and is not as well circumscribed. (c) Fat-suppressed dynamic-enhanced MR image performed at the time of second ultrasound shows a 1.8 cm well-circumscribed, enhancing nodule. (d) Fat-suppressed dynamic-enhanced MR image 1 year after the previous MRI shows a heterogeneously enhancing mass that has doubled in size. (e) Left CC mammogram at the time of diagnosis of malignant phyllodes tumor shows a dominant mass with biopsy marker clip. Other marker clips are present in additional previously biopsied stable fibroadenomas.
© Copyright Policy - creative-commons
Related In: Results  -  Collection

License 1 - License 2 - License 3
Show All Figures
getmorefigures.php?uid=PMC4548734&req=5

fig1-2058460115592061: (a) A 40-year-old woman. US image at the time of initial core biopsy demonstrates a 1.8 cm well-circumscribed, hypoechoic lesion, consistent with a fibroadenoma. (b) Three years later, the FA is stable in size, but shows slight heterogeneity and is not as well circumscribed. (c) Fat-suppressed dynamic-enhanced MR image performed at the time of second ultrasound shows a 1.8 cm well-circumscribed, enhancing nodule. (d) Fat-suppressed dynamic-enhanced MR image 1 year after the previous MRI shows a heterogeneously enhancing mass that has doubled in size. (e) Left CC mammogram at the time of diagnosis of malignant phyllodes tumor shows a dominant mass with biopsy marker clip. Other marker clips are present in additional previously biopsied stable fibroadenomas.
Mentions: A 40-year-old woman with a history of prior biopsy of a benign fibroadenoma (FA) presented for routine screening mammogram and breast ultrasound. On screening ultrasound, a new 1.8 cm hypoechoic lesion was visualized in the lateral left breast (Fig. 1a). Subsequent ultrasound-guided biopsy revealed another benign FA. This FA remained stable in size and appearance both mammographically and sonographically over the next 3 years (Fig. 1b). Breast MRI (performed on Philipps Achieve 1.5 T magnet, with T1, T2 sequences, fat suppressed dynamic sequences following i.v. gadolinium by patient weight) ordered for high-risk screening within this 3-year time interval demonstrated a 1.8 cm well-circumscribed, mostly T2 hyperintense, enhancing lesion containing a biopsy clip in the lateral left breast (Fig. 1c).Fig. 1.

Bottom Line: The transformation of a benign fibroadenoma into a phyllodes tumor is uncommon and unpredictable.We present ultrasound and magnetic resonance images, as well as pathology slides from core biopsy and surgical excision, to illustrate this transformation.However, in this case, pathology supports correct initial diagnosis of fibroadenoma and demonstrates a portion of the original fibroadenoma along the periphery of the malignant phyllodes tumor.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Breast Center, Barnabas Health Care Systems, Livingston, NJ, USA.

ABSTRACT
The transformation of a benign fibroadenoma into a phyllodes tumor is uncommon and unpredictable. We report the case of a 40-year-old woman with a core biopsy proven fibroadenoma that underwent transformation into a malignant phyllodes tumor after 3 years of size stability. We present ultrasound and magnetic resonance images, as well as pathology slides from core biopsy and surgical excision, to illustrate this transformation. It has been suggested that phyllodes tumors may be misdiagnosed as fibroadenomas by core biopsy. However, in this case, pathology supports correct initial diagnosis of fibroadenoma and demonstrates a portion of the original fibroadenoma along the periphery of the malignant phyllodes tumor.

No MeSH data available.


Related in: MedlinePlus