Phyllodes tumor of right breast with metastasis to lungs, rare presentation

Authors

  • Prabhat B. Nichkaode Department of Surgery, Chandulal Chandrakar Memorial Medical College, Kachandur, Durg, Chhattisgarh, India
  • Sachin Kumar Patel Department of Surgery, NKP Salve Institute of Medical Sciences, Maharashtra, India

DOI:

https://doi.org/10.18203/2349-2902.isj20173914

Keywords:

Breast, Malignant potential, Metastasis, Phylloids tumor, Surgery

Abstract

Incidence of Phylloids tumor of the breast is between 0.5% to 2% of all breast tumors. Most common age of occurrence is between 45-49 years but it can occur even at younger age. It is important to distinguish it from more benign tumors of the breast like fibroadenoma as far the management is concerned. Phylloids are fibroepethilial tumors with malignant potential, so needs complete excision. We present a case of 53 years female who underwent simple mastectomy for high grade Phylloids tumor in her right breast a year back, presented with breathlessness and local recurrence, proved to be metastatic Phylloids to lung causing left pleural effusion and nodule in the right upper lobe of lung. When the effusion was tapped it appeared to be pleomorphic spindle cell metastasis.

References

Bernstein L, Deapen D, Ross RK. The descriptive epidemiology of malignant cystosarcoma phyllodes tumors of the breast. Cancer 1993;71:3020-4.

Chaney AW, Pollack A, Mcneese MD, Zagars GK, Pisters PW, Pollock RE, et al. Primary treatment of cystosarcoma phyllodes of the breast. Cancer. 2000;89(7):1502-11.

Mangi AA, Smith BL, Gadd MA, Tanabe KK, Ott MJ, Souba WW. Surgical management of phyllodes tumors. Arch Surg. 1999;134(5):487-92.

Lee AH. Recent developments in the histological diagnosis of spindle cell carcinoma, fibromatosis and phyllodes tumour of the breast. Histopathol. 2008;52:45-57.

Lee AH, Hodi Z, Ellis IO, Elston CW. Histological features useful in the distinction of phyllodes tumour and fibroadenoma on needle core biopsy of the breast. Histopathol. 2007;51:336-44.

Pietruszka M, Barnes L. Cystosarcoma phyllodes: a clinicopathologic analysis of 42 cases. Cancer. 1978;41:1974-83.

Jang JH, Choi MY, Lee SK, Kim S, Kim J, Lee J, et al. Clinicopathologic risk factors for the local recurrence of phyllodes tumors of the breast. Ann Surg Oncol. 2012;19(8):2612-7.

Spitaleri G, Toesca A, Botteri E, Bottiglieri L, Rotmensz N, Boselli S, et al. Breast phyllodes tumor: a review of literature and a single center retrospective series analysis. Critical Rev Oncol/Hematol. 2013;88(2):427-36.

Chen WH, Cheng SP, Tzen CY, Yang TL, Jeng KS, Liu CL, et al. Surgical treatment of phyllodes tumors of the breast: retrospective review of 172 cases. J Surg Oncol. 2005;91(3):185-94.

Roberts N, Runk DM. Aggressive malignant phyllodes tumor. Int J Surg Case Rep. 2015;8C:161-5.

Telli ML, Horst KC, Guardino AE, Dirbas FM, Carlson RW. Phyllodes tumors of the breast: natural history, diagnosis, and treatment. JNCCN. 2007;5(3):324-30.

Tan PH, Tse G, Lee A. Fibroepithelial tumours. Lakhani SR, Ellis IO, Schnitt SJ, editors. WHO classification of tumours of the breast. Lyon: IARC Press; 2012:142-147.

Reinfuss M, Mitus J, Duda K, Stelmach A, Rys J, Smolak K. The treatment and prognosis of patients with phyllodes tumor of the breast: an analysis of 170 cases. Cancer. 1996;77(5):910-16.

Kapiris I, Nasiri N, A’Hern R, Healy V, Gui GP. Outcome and predictive factors of local recurrence and distant metastases following primary surgical treatment of high-grade malignant phyllodes tumours of the breast. Eur J Surg Oncol. 2001;27(8):723-30.

Tse GM, Niu Y, Shi HJ. Phyllodes tumor of the breast: an update. Breast Cancer. 2010;17(1):29-34.

Burton GV, Hart LL, Leight GS, Iglehart JD, McCarty KS, Cox EB. Cystosarcoma phyllodes. Effective therapy with cisplatin and etoposide chemotherapy. Cancer. 1989;63(11):2088-92.

Dillon MF, Quinn CM, McDermott EW, O’Doherty A, O’Higgins N, Hill AD. Needle core biopsy in the diagnosis of phyllodes neoplasm. Surg. 2006;140(5):779-84.

Kamitani T, Matsuo Y, Yabuuchi H, Fujita N, Nagao M, Kawanami S, et al. Differentiation between benign phyllodes tumors and fibroadenomas of the breast on MR imaging. Eu J Radiol. 2014;83(8):1344-9.

Theriault RL, Carlson RW, Allred C, Anderson BO, Burstein HJ, Edge SB, et al. Breast cancer, version 3.2013. J National Comprehensive Cancer Network. 2013;11(7):753-61.

Downloads

Published

2017-08-24

Issue

Section

Case Reports