Cystosarcoma phyllodes mammae, fibrosarcoma variant mdedge. Jul 04, 2016 surgery is the main treatment for phyllodes tumors of the breast. Abstractthe term cystosarcoma phyllodes, originating more than a century ago is attributed to johannes muller who, in 1838, utilized it to designate the cauliflowerlike masses of connective tissue which fill a cystic cavity in the breast. May 11, 2017 a phyllodes tumor is a rare tumor of the breast. They account for less than 1% of all breast neoplasms. However, in the setting where additional recurrence would create significant. They are graded as benign, borderline or malignant based on the world health organisation who classification, according to a constellation of 5. Pathologic, immunohistochemical, and molecular features. Histopathologic features, differential diagnosis, and moleculargenetic updates. A rare variant of high grade ductal carcinoma, nos. The phyllodes tumor presents related challenges on histopathological diagnostic criteria, clinical behavior, preoperative diagnosis. An unique case of highgrade phyllodes tumor cystosarcoma phyllodes arising in the seminal vesicle is reported. Cystosarcoma phyllodes is a rare, predominantly benign tumor that occurs almost exclusively in the female breast. Only histopathologically confirmed cases of phyllodes tumor were included in the study.
Jul 23, 2019 cystosarcoma phyllodes is a rare, predominantly benign tumor that occurs almost exclusively in the female breast. Phyllodes tumors are uncommon fibroepithelial breast tumors that are capable of a diverse range of biologic behaviors. Phyllodes tumors of the breast the role of pathologic parameters. Cystosarcoma phyllodes is listed as a rare disease by the office of rare diseases ord of the national institutes of health nih. Phyllodes tumour is a tumour of the intralobular breast stroma. Missed diagnosis of phyllodes tumor and its implications. Ultrasound and xray mammograms were obtained in 8 patients with palpable breast masses, which were subsequently proven to be cystosarcoma phylloides. I was diagnosed with a very rare tumor referred to as cystosarcoma phyllodes. It may be benign or malignant it was previously called cystosarcoma phyllodes. With the nonoperative management of fibroadenomas widely adopted, the importance of phyllodes tumours today lies in the need to differentiate them from other benign breast lesions. A 61yearold man had symptoms of urinary obstruction, and ultrasonography and computed tomography showed a large mass posterior to the bladder. Phyllodes tumor of the breast genetic and rare diseases.
Dec 16, 20 the present study confirmed this observation. Jan 22, 2020 the most common symptom of a phyllodes tumor is a painless breast lump that you or your doctor can feel while examining the breasts. Significant histologic features differentiating cellular fibroadenoma from phyllodes tumor on core needle biopsy specimens saba yasir, mbbs 1 department of laboratory medicine and pathology, mayo clinic, rochester, mn. Mar 20, 20 depending on the size of the breast and the location of the phyllodes tumor, mastectomy may also be required for tumors that are between 5 and 10 cm in diameter. After an ultrasound, mammogram, and needle biopsy, i was told that this 2 cm tumor was nothing to worry about and that it was ok to leave it. Diagnostic imaging and histopathology findings phyllodes tumors are rare breast tumors, accounting for less than 1% of all primary tumors of the breast. The term cystosarcoma phyllodes was first introduced by muller in 1838. Phyllodes tumor of the breast surgical pathology criteria.
If the phyllodes tumor of the breast is benign or borderline histology, radiation therapy. There were eight benign, one borderline and one malignant phyllodes tumor. Files are available under licenses specified on their description page. This includes the tissue and ligaments that surround the ducts. Phyllodes tumor of the breast histopathologic features, differential diagnosis, and moleculargenetic updates yanhong zhang, md. The epidemiology and pathobiology are different from those of breast carcinoma. The correlation between the histology and biologic behavior of phyllodes tumor was studied in order to establish the histologic criteria of this tumor, particularly. The phyllodes tumor was described by johannes muller, who named it as cystosarcoma phyllodes because of the tumors fleshy appearance and tendency to contain cystic spaces. This term is, however, a misnomer as they are usually benign. Phyllodes tumors are rare fibroepithelial neoplasms that account for 0.
The most important diagnostic distinction is from fibroadenomaphyllodes tumors. This means that cystosarcoma phyllodes, or a subtype of cystosarcoma phyllodes, affects less than 200,000 people in the us population. Cystosarcoma phyllodes is a very rare tumor which may be difficult to diagnose clinically. In their least aggressive form, phyllodes tumors behave like benign fibroadenomas, although with a propensity to recur locally following excision without wide margins. Diagnosing phyllodes tumors usually involves a combination of steps, such as a physical exam, a mammogram, and a biopsy. To illustrate the spectrum of imaging findings in cystosarcoma phyllodes of the breast and discuss its differential diagnosis. While managing a giant phyllodes tumor, emphasis should be on complete extirpation of all visible tumors and breast tissue during mastectomy to minimize the chances of recurrence.
Further, more phyllodes tumors increased in size over time 32% for phyllodes tumors and 14% for fibroadenomas, p 0. Jan 19, 20 phyllodes tumor bears specific clinical characteristic and can be considered as a differential diagnosis for the breast lumps. A comparison of histopathology between the initially excised and recurrent tumors indicated no marked changes in any patient. Adverse features stromal overgrowth one 40x field without epithelium high mitotic index 10 10 hpf. The biological features of these tumors include latent malignancy and the tumors.
Cystosarcoma phyllodes of breast revisited spectrum of. Learn more about the symptoms and diagnosis of phyllodes tumors. The tumor is rarely found in adolescents and the elderly. Phyllodes tumor of the breast textbook of uncommon. Although the term sarcoma indicates a malignant tumor, only 10%30% of.
Phyllodes tumors are biphasic tumors, histologically characterized by a lea. Phyllodes tumor pt of the breast is a rare fibroepithelial neoplasm, accounting for 0. The term cystosarcoma phyllodes was coined by johannes muller in 1838 to describe the gross appearance of this cystic, fleshy, leafy, tumor of the breast, which he clearly stated to be a benign tumor. The classification of pt proposed by the world health organization who into benign, borderline, and malignant is based on a combination of several histologic features, including stromal cellularity. This is the case regardless of whether they are benign or malignant. Phyllodes tumor is a rare fibroepithelial neoplasm of the breast with a very variable, but usually benign, course. Media in category histopathology of cystosarcoma phyllodes the following 5 files are in this category, out of 5 total. Phyllodes tumor page 1 of 4 md anderson cancer center. Primary treatment of cystosarcoma phyllodes of the breast. All structured data from the file and property namespaces is available under the creative commons cc0 license. Pdf cystosarcoma phyllodes, rapidly growing tumours with.
Risk factors, multicentricity, bilaterality, as associated with breast carcinoma, are not observed in patients with cystosarcoma phyllodes. Cystosarcoma phyllodes symptoms, diagnosis, treatments and. In january of 2009, just days after my 34th birthday, i found a very noticeable lump in my right breast. Background cystosarcoma phyllodes is a rare fibroepitheleal tumor of the breast, accounting for 0. Cystosarcoma phyllodes of the seminal vesicle mayo clinic. Grading staging report phyllodes tumor of the breast. Cancer, phyllodes tumor of the breast cystosarcoma statpearls. All breast lumps should be triple assessed and the diagnosis of a phyllodes tumour considered in women.
Phyllodes tumor of the breast is a rare biphasic fibroepithelial neoplasm that has the potential for recurrence and metastases. A rare type of breast cancer that may be benign or malignant. Surgery has been the primary mode of treatment to date. Although phyllodes tumor may have been described as early as the 1770 s, it was first fully characterized in 1838by johannes muller, who used the term cystosarcoma phyllodes. Cystosarcoma phyllodes phyllodes tumor of the male breast. Phyllodes tumor of the breast textbook of uncommon cancer. Aug 14, 2017 the overall appearances was felt to be in keeping with a phyllodes tumour of the urinary bladder, low. Phyllodes tumours pts of the breast are uncommon fibroepithelial neoplasms, comprising 0. Phyllodes tumors form well circumscribed, firm, protruding masses. The preoperative diagnosis and proper management are crucial in phyllodes tumor because of their tendency to recur and malignant potential in some of these tumors. Numerous studies have attempted to analyse the histology of phyllodes tumours. The patient had an uneventful postoperative course and, as of the time of writing, there has been no evidence of recurrence. A variety of terms have been used to describe these tumors, the most common being cystosarcoma phyllodes, cellular. Phyllodes tumors of breast comprising of both stromal and epithelial elements are rare tumors.
From the department of pathology and laboratory medicine, university of california, davis medical center. Pdf phyllodes tumor pt also known as cystosarcoma phyllodes are. Nov, 2000 cystosarcoma phyllodes is an uncommon fibroepithelial breast neoplasm that accounts for 0. First described in 1838 by johannes muller, cystosarcoma phyllodes was initially thought to be a benign lesion. Phyllodes tumor of the breast archives of pathology. Significant histologic features differentiating cellular. Adverse features stromal overgrowth one 40x field without epithelium. Symptoms and diagnosis of phyllodes tumors of the breast. Phyllodes tumours vary greatly in size with most series reporting lesions up to 20 cm in diameter. Histopathology of cystosarcoma phyllodes wikimedia. Formerly known as cystosarcoma phyllodes, the designation phyllodes tumor with appropriate qualification regarding malignant potential based on pathologic features is now the agreedupon term. Phyllodes tumor of the breast definition mixed epithelial and stromalmesenchymal proliferation of breast characterized by increased stromal cellularity and characteristic broad leaflike papillae inserted into cleftlike spaces. Ultrasound, xray mammography, and histopathology of.
Distant metastases in phyllodes tumours of the breast. Phyllodes tumor pt of the breast is a rare fibroepithelial neoplasm with risks of local recurrence and uncommon metastases. The term cystosarcoma phyllodes was first described by. Phyllodes tumors, which comprise less than 1% of all breast tumors, can be classified into benign ben, borderline bdr and malignant mal grades based on the assessment of five histological. The name is derived from the greek terms phyllos leaf and eidos form. Cystosarcoma phyllodes of the breast is a rare neoplasm of fibroepithelial origin thought to occur almost exclusively in females. Traditional histological classification as benign, borderline or malignant. Phyllodes tumors grow in the connective tissue of the breast, called the stroma. Primary sarcomas of the breast are rare accounting for less than 0. Because these tumors can come back if enough normal tissue is not removed, surgery should involve removing the tumor and at least 1 cm of the surrounding tissue. Phyllodes tumors are rare, accounting for less than 1% of all cases of mammary tumors 1,26. Phyllodes tumours are rare fibroepithelial lesions that account for less than 1% of all breast neoplasms.
923 1354 388 1037 1548 520 1365 1239 1185 976 1026 926 1243 436 1256 1017 22 1315 198 590 303 51 1556 944 148 1481 1265 118 399 473 520 841 1149 936 123 65 476 977 1121 30 629 763 11 1177