[Giant-cell tumor (osteoclastoma) developing from a phyllode tumor of the breast].
Explore the source record for details and available documents.
Bone Neoplasms↗
SEARCH · Search PubMed
Results for “Phyllodes Tumor”
Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
Phyllodes tumor of the prostate: long-term followup study of 23 cases.
PURPOSE: Phyllodes tumor of the prostate is a rare neoplasm of uncertain malignant potential. We studied a large series of phyllodes tumors to define the combination of histological features that are most useful for predicting patient outcome. MATERIALS AND METHODS: A total of 23 cases were obtained from our collective files from 1973 to 2002, and numerous clinical and pathological features were evaluated. A review of the reported cases of phyllodes tumor of the prostate was done. RESULTS: Patient age was 25 to 86 years (mean 55) and they usually presented with urinary obstructive symptoms and hematuria. The diagnosis was made in 18 tumors by transurethral resection, in 2 by enucleation, in 1 by tumor resection and in 2 by prostatectomy. We analyzed 5 histological features, including cellularity (scale of 1 to 3), cytologic atypia (scale of 1 to 3), the number of mitotic figures per 10 high power fields, the stroma-to-epithelium ratio (low or high) and necrosis (present or absent). This combination of features revealed that 14 cases were low grade phyllodes tumor, 7 were intermediate grade and 2 were high grade with the high grade cases characterized by increased cellularity, severe cytological atypia, more than 5 mitotic figures per 10 high power fields and a high stroma-to-epithelium ratio, indicating stromal overgrowth. Immunohistochemical studies of 8 tumors revealed consistent, intense cytoplasmic immunoreactivity in stromal cells for vimentin and actin, in luminal epithelial cells for prostate specific antigen, prostatic acid phosphatase and broad-spectrum keratin AE1/AE3, and in basal cells for high molecular weight keratin 34beta-E12. Recurrence was seen in 7 of 14 low grade tumors (50%) and in 1 patient low grade sarcoma emerged with subsequent distant metastases 14 years after initial diagnosis following 5 recurrences. Recurrence was seen in 6 of 7 intermediate grade tumors and low grade sarcoma emerged with subsequent abdominal wall metastases in 1 patient 11 years after initial diagnosis following 3 recurrences. The phyllodes tumor recurred in each patient with high grade tumors with a time to first recurrence of 6 and 0.2 years, respectively. Distant metastases developed in these 2 patients. CONCLUSIONS: Histological grading of prostatic phyllodes tumors is predictive of short-term outcome based on the combination of stromal cellularity, cytological atypia, number of mitotic figures and the stroma-to-epithelium ratio. However, these tumors usually recur after transurethral prostatic resection and they are often locally aggressive with time. The emergence of overt sarcoma and metastatic disease is more frequent than previously recognized. Complete resection at initial diagnosis appears to be indicated.
Acid Phosphatase↗
Phyllodes tumor showing intracystic growth: a case report.
A phyllodes tumor often grows rapidly and occasionally contains microcysts; however, the tumor rarely shows a morphologically intracystic pattern. We experienced a rare case of a phyllodes tumor with a solid mass growing into the cyst. A 62-year-old female noticed a tumor in her right breast in January 1995. The tumor grew rapidly and she visited our out-patient clinic in February 1995. On physical examination, a 10 x 8 cm, well defined and movable mass with a smooth surface was palpated in the upper outer quadrant of the right breast. Mammography showed a large tumor shadow in the upper outer quadrant of the right breast without any microcalcification. Ultrasonography revealed a large cystic shadow with a low echoic lesion and solid component with heterogeneous internal echo in the cyst. Under general anesthesia, the tumor was widely excised. The resected specimen was 11.5 x 11 x 11 cm in size and the tumor was not invasive to surrounding tissues. Old bloody fluid was contained within the cyst. The gross appearance showed papillary process protrusions into a central cystic cavity. Histological examination revealed a borderline case of phyllodes tumor. Two years after the operation, she is doing well without any recurrence.
Breast Neoplasms↗
A Case of Phyllodes Tumor with Bloody Nipple Discharge in Juvenile Patient.
We report a rare case of phyllodes tumor of the breast in a juvenile patient with bloody nipple discharge. An 11-year-old girl had a chief complaint of a palpable 5 cm well-circumscribed tumor with nipple discharge in the left breast. The histopathological diagnosis of the resected specimen was benign phyllodes tumor showing extensive areas of hemorrhagic necrosis. The bloody nipple discharge was caused by spontaneous infarction of the tumor. Preoperative ultrasonography and galactography were helpful in evaluating the mechanism of nipple dicharge from the tumor. Although phyllodes tumor must be differentiated from fibroadenoma, the present case was histopathologically identical to phyllodes tumor.
Journal Article↗
[Phyllodes tumor of the prostate: a case report].
Prostatic phyllodes tumor is an unusual lesion for which there are only occasional reports in the literature. We encountered a phyllodes tumor of the prostate in a 36-year-old man who had complained of urinary frequency and dysuria for one month. In October 1998, he visited our hospital and had a transurethral resection of the prostate (TUR-P) for obstructive symptoms. He experienced recurrent same symptoms in September 1999 and underwent another TUR-P. The pathologic examination at this time revealed phyllodes tumor. In the tumor, despite its regular alternating growth of ducts and stroma, the stromal element appeared histologically malignant, showing marked atypia and rhabdomyosarcoma-like components. Consequently, in December 1999, the patient underwent radical prostatectomy with lymph node dissection. The resection margins and pelvic lymph nodes were free of tumor. The patient remains alive and well after 14 months.
Adult↗
Differentiation of phyllodes tumors versus fibroadenomas.
PURPOSE: To determine if mammographic and sonographic findings allow discrimination between phyllodes tumor and large sized fibroadenoma, which mimic each other in the clinical, radiologic and histopathologic appearances. MATERIAL AND METHODS: Thirty-one histopathologically proven masses including 12 phyllodes tumors and 19 fibroadenomas 3 cm or greater in diameter were compared. In total 28 women were retrospectively evaluated by mammography and pre-operative sonography. RESULTS: Mammography revealed a high-density mass compared with surrounding fibroglandular breast tissue to be present in 9 of the 12 (75%) phyllodes tumors and 7 of the 19 (37%) fibroadenomas. At sonography a mass, which had a round or lobulated shape, marked posterior acoustic enhancement and intramural cystic areas, were statistically significantly more likely to be phyllodes tumors than fibroadenomas. None of the other mammographic or sonographic characteristics proved to be useful in differentiating phyllodes tumors and fibroadenomas. CONCLUSION: Although masses of high density at mammography, circumscribed border associated with posterior acoustic enhancement and internal cystic areas at sonography should suggest the diagnosis of phyllodes tumors rather than large sized fibroadenomas, there was a substantial overlap in the mammographic and sonographic characteristics of these two tumors. Therefore, an excisional biopsy would be necessary for equivocal masses.
Adult↗
Phyllodes tumors of the breast.
Our objective was to study the color and pulse Doppler ultrasonography of phyllodes tumors of the breast. The data of 36 phyllodes tumors (19 benign, 5 borderline, and 12 malignant) were reviewed retrospectively. The median age of the patients was 41.5 years (range 13-62 years), and the tumors varied in size from 1.5 to 20 cm (median 4.6 cm). Most of the phyllodes tumors were lobulated masses with smooth margins, mildly hypoechoic internal echo texture, a heterogeneous internal echo pattern, and no microcalcification. Vessels were detectable on 35 of these tumors, with 51.4% having resistance index >0.700, 45.7% having pulsatility index >1.300, and 51.4% having V(max) >15 cm/s. The color Doppler characteristics were of no significant use in predicting the histological nature of the phyllodes tumors. If the sonographic features suggest a phyllodes tumor, a histological examination should be conducted to confirm the diagnosis.
Adolescent↗
Phyllodes tumor in epileptics: a report of two cases.
Phyllodes tumor is an uncommon breast neoplasm characterized by a proliferation of both stromal and epithelial elements. In 1989, two young patients with phyllodes tumors were referred to our surgical department because of the detection of breast lumps. Interestingly, both patients also had epilepsy and had been taking anticonvulsants. An analytical case control study revealed that no significant difference between the control group and phyllodes group was found for various categories. In addition, no anticonvulsant medication had been prescribed in either the control group or the phyllodes group except for these two cases. We herein report two cases of phyllodes tumors occurring in two young epileptic patients.
Adolescent↗
Karyotypic changes in phyllodes tumors of the breast.
Cytogenetic analysis of short-term cultures of five phyllodes tumors of the breast-classified as benign (one tumor), borderline malignant (two tumors removed from the same breast in 1991 and 1993), and malignant (two tumors)--revealed clonal changes with simple structural abnormalities in the benign tumor, the borderline malignant tumors, and one malignant tumor in which benign areas and areas of borderline malignancy were also present. In contrast, the malignant tumor without admixed borderline malignant or benign areas had a complex karyotype. The karyotype of the benign phyllodes tumor was 46,XX,del(12)(p11p12)/46,XX,t(8;18)(p11;p11)/46,XX. The first borderline malignant phyllodes tumor had t(3;20)(p21;q13) as the sole abnormality. When the tumor recurred, this was no longer the only clone detected and the tumor karyotype was now 46,XX,t(3;20)(p21;q13)/46,XX,t(9;10)(p22;q22)/46,XX,t(1;8) (p34;q24)/46,XX,del(11)(q22-23)/46,XX. The malignant/borderline malignant/benign tumor had t(1;6)(p34;p22) as the sole clonal abnormality. Finally, the karyotype of the malignant phyllodes tumor which contained no benign or borderline malignant areas was 42,XX,der(1)t(1;4)(q21;q21),der(3)t(3;17)(q29;q21), -4,i(8)(q10), -10, -13,i(13)(q10),der(14)t(1;14)(q21;p11),der(14)t(4;14) (p12;p11), -17/80-90,idemx2, +del(1)(q12), +i(1)(p10), +dic(5;5)(p14;p14), +i(6)(p10), +del(7)(p11), +dup(7)(q11q36), +i(15)(q10),inc/46,XX. The findings indicate some cytogenetic similarities between benign/borderline malignant phyllodes tumors and fibroadenomas of the breast, presumably reflecting similar pathogenetic mechanisms in the two types of mixed-lineage tumors.
Aged↗
Immunohistochemical study of MIB1 expression in phyllodes tumor and fibroadenoma.
The histogenesis of phyllodes tumor (PT) and fibroadenoma (FA) is closely related, and discrimination between them by histopathological analysis is sometimes problematic. Moreover, objective criteria by which to categorize the grade of malignancy in PT are still controversial. The aim in this study is to clarify whether immunohistochemical evaluation using the MIB1 antibody, which reacts with the ki-67 antigen, correlates with the histological grade of malignancy in PT, and can discriminate between PT and FA. The 47 cases of phyllodes tumor (PT) were categorized into three groups (malignant, 4 cases; borderline, 6 cases; benign, 37 cases) according to the criteria proposed by Azzopardi (1979) and were investigated by immunohistochemistry. There were significant differences in stromal MIB1-index among the three groups (P < 0. 0001), and, unexpectedly, benign PT was easily divided into two groups according only to the MIB1-index. There were significant differences in the stromal MIB1-index (P < 0.001) and stromal cellularity (P < 0.01) between the two benign PT groups. A total of 478 cases of FA was reviewed and these were divided into 403 conventional fibroadenomas (CFA), 36 cellular fibroadenomas (CEFA) and 39 fibroadenomas with focal phyllodes structure (FAPS). All cases of CEFA and FAPS, and 140 cases of CFA were studied by immunohistochemistry. The 21/215 (9.8%) cases of FA, which were designated as FAMIB, showed a high stromal MlB1-index (more than 10/0.0625 mm2). Conversely, 77% cases of FA showed no MIB1-positive stromal cells. The incidence of MIB1-positive epithelium of FAMIB was much higher than that of FA. These results suggest that high proliferative activity may be present in both stromal and epithelial cells of FAMIB. Our study suggests that immunohistochemical evaluation using MIB1 antibody correlates with the histological grade of malignancy in PT, and can select FA with high proliferative activity. However, new objective diagnostic factors useful for discriminating FA from benign PT with a low MIB1-index should be developed.
Adenoma↗
[Therapy concept in phyllodes tumors of the breast].
The data of 22 women with a phyllode tumor of breast operated in our department from 1980 to 1997 were analysed. 11 benign, 7 borderline and 7 malign phyllode tumors were found in accordance to WHO-classification. In conclusion diameter of tumor is a relevant prognostic factor beside histologic classification. Therefore local excision is recommended for benign and borderline phyllode tumors smaller than 5 cm. A safety distance of 1 cm is claimed. Benign or borderline lesions greater than 5 cm and all malign require a simple mastectomy. Only recurrence smaller than 5 cm after excision of benign and borderline phyllode tumor should excised once more. Metastasis have to be cured by surgical therapy.
Adolescent↗
Phyllodes tumor of the breast: the challenge persists.
INTRODUCTION: Phyllodes tumors of the breast are uncommon, and it is difficult to predict biologic behavior based on clinicopathologic features. Despite the wealth of data on the factors to predict recurrence, little is known about the impact of treatment refinements. This study seeks to define changes in patient characteristics, histopathologic parameters, and outcome between the two periods before and after the care of patients with breast diseases was centralized to a breast specialty. METHODS: The records of 182 patients with phyllodes tumors managed surgically were reviewed. Patients treated from 1985 to 1996 (n=81) were compared with those seen from 1997 to 2004 (n=101). RESULTS: The analysis of the two treatment periods revealed that there was a decrease in tumor size at diagnosis, from 7.7 cm during the earlier period to 4.6 cm during the recent period (P=0.003). The patients undergoing breast-conserving surgery were significantly increased during the recent period. In contrast, pathologic features and local recurrence rates remained unchanged during the study period. Multivariate analysis revealed that positive surgical margin was the only independent predictor of recurrence, with an increased hazard of 8.0. Overall, upgrading to the next grade was observed in 16% of recurrences. CONCLUSIONS: Breast-conserving surgery with clear margins is the current treatment of choice for phyllodes tumors, but this strategy does not further reduce local recurrence effectively. Optimal management continues to be a challenge.
Adolescent↗
Malignant phyllodes tumor of the breast metastasizing to the pancreas: case report.
Phyllodes tumor of the breast, or cystosarcoma phyllodes, is an unusual breast tumor. It is usually considered a benign lesion but may have malignant potential. Only a small proportion of malignant phyllodes tumors will metastasize. A phyllodes tumor of the breast metastasizing to the pancreas is rare. This 39-year-old female patient initially presented to us with a 5 x 4 x 2 cm tumor of a right breast. After excision of the tumor, she received another wise excision for a local recurrence of the tumor. Three years had passed when she started having hematemesis and tarry stools intermittently over a period of about one month. Clinical evaluation disclosed a huge mass with an ulcerated and bloody base over the second portion of the duodenum. A pancreatoduodenectomy was then performed. During the postoperative recovery period, a rapidly enlarging tumor of the right breast was noted. She subsequently underwent a total mastectomy of the right breast. Both the duodenal tumor and the breast tumor were found to be malignant phyllodes tumors. The rarity of this kind of patient and presentation is discussed.
Adult↗
[Phyllodes tumor of the breast (cystosarcoma phyllodes) (apropos 3 cases)].
There have been described three cases of the breast phyllodes tumour, i.e., fibroepithelial tumour, histologically both benign and on borderline, or expressively malignant (sarcoma). The mean age of patients concerned is of about 50 years old at the time of neoplasm diagnosis. If the surgical removal is incomplete, therein a large number of recurrences occurs. Diagnostic procedures are based on clinical examination (it is remarked the abnormal wideness of the tumour) as well as mammography, echography, needle biopsy. Surgical treatment is always based on large tumorectomy which results are sufficient in benign tumours. In malignant phylloides a total mastectomy is required without axillary lymphadenectomy owing to the hematic dissemination. Usually, after surgical treatment, survival rate seems better as compared to that of breast cancer.
Aged↗
Fine needle aspiration cytopathology of phyllodes tumor. Differential diagnosis with fibroadenoma.
The differential diagnosis of benign or borderline phyllodes tumors of the breast in fine needle aspiration biopsy smears was studied. Smears from five histologically proven cases and 20 proven cases of fibroadenoma were evaluated with regard to their cytologic features. The findings indicate that the presence of a high cellularity of stromal fragments (including bipolar naked nuclei), clusters of hyperplastic ductal cells and giant cells and the absence of apocrine metaplasia may suggest a diagnosis of phyllodes tumor, as opposed to fibroadenoma. The borderline phyllodes tumor showed a sarcomatous atypia and/or small intranuclear cytoplasmic invaginations in some cells. The differential diagnosis of this tumor with malignant phyllodes tumor and plasma-cell mastitis is also discussed.
Adenofibroma↗
Phyllodes tumor of the breast: problems of differential diagnosis and therapeutic approach from an analysis of 17 cases.
Retrospective analysis of 17 cases of phyllodes tumor with a follow-up of almost 1 year revealed no close correlation between histological pattern and clinical course, since local relapse occurs even after histological findings of benign lesion in the primary tumor. Phyllodes and fibroadenoma patterns are often associated in the same patient and extensive surgery is not recommended owing to the fact that recurrences are observed both after subcutaneous mastectomy and after simple resection. We conclude that local control of the disease by wedge resection and strict follow-up may be the most rational approach.
Adolescent↗
A Malignant Phyllodes Tumor of the Breast in a 6-Year Old Girl.
We recently encountered a 6-year-old girl with a malignant phyllodes tumor of the breast. The patient's mother noticed a tumor on the right breast of her first doughter at 8 months after from her birth. The baby was brought to the Second Depertment of Surgery, University of Tokushima, at age 20 months. We recommended removal of the 3.5 x 2.9 cm tumor in the right breast, but it was not done. Next, she visited our department at 6 years of age because the tumor had gradually enlarged, reaching a size of 4.3 &timus; 4.0 cm. She underwent excisional resection of the tumor, and the tumor was diagnosed as a malignant phyllodes tumor of the breast coexisting with a borderline phyllodes tumor. To our knowledge, this is the youngest reported case of a malignant phyllodes tumor of the breast. Moreover, the malignant lesion was positive for estrogen receptor (ER) and showed strong proliferating cell nuclear antigen (PCNA) staining. On the other hand, the borderline part was negative for ER and showed weak PCNA staining. Thus, in the present case, the expression of ER, the exposure to estrogen (for example, the mother's estrogen during gestation) and increase in the proliferation rate may have played important roles in the mechanism of the transformation of the phyllodes tumor.
Journal Article↗
Unusual clinical presentation of a rare case of phyllodes tumor of the breast in an adolescent girl.
Phyllodes tumor of the breast is a very rare neoplasm, particularly in adolescent girls and young women. It usually presents as unilateral palpable mass. The authors report the case of an adolescent girl who presented at the Emergency Department with bloody nipple discharge. Although the clinical signs suggested an intraductal tumor, the histologic examination showed a phyllodes tumor. The management and the biologic behavior of this uncommon tumor are discussed with particular regard to the very unusual clinical presentation in this patient. J Pediatr Surg 36:941-943.
Adolescent↗