Background: Phylloid sarcomas are rare. There is not enough data to codify the management. Objectives: The objective was to study the clinical and therapeutic aspects and the fate of patients after a follow-up of at least 4 years. Thus contributing to the limited body of knowledge on these tumors. Methods: a retrospective analysis of the files from 2013 to 2017 was carried out and patients were followed up until 2021at Hassan II Hospital. Epidemiological, clinical and therapeutic aspects were studied. Survival was calculated using the Kaplan-Meier method. Results: We collected 12 charts of patients treated for phyllodeal sarcoma from 2013 to 2017. The median age was 43 years. The circumstance of discovery was marked by the presence of nodule in all patients. The coupled echo-mammography examination classified the nodules, ACR 4 in 7 patients and ACR 3 in 3 and ACR 5 in 2 patients. Histological examination revealed a phylloid sarcoma in 11 patients and a borderline phylloid tumor in 1 patient. All patients had radical surgery with positive margins in 2 patients, 16.66%. One patient had revision surgery. Histological examination of the surgical specimens showed phylloid sarcoma on all specimens. All patients had adjuvant radiotherapy with doses of 50 Gy in 25 fractions of 2 Gy and a boost of 10 Gy was done in one patient. The median spread of radiotherapy was 37 days. Grade 1 and 2 skin toxicities were noted in 5 and 3 patients respectively. The median time from surgery to radiotherapy was 2.95 months. 3 patients relapsed after 13.
Un myofibroblastome de type mammaire est une tumeur molle rare; les myofibroblastomes extramammaires sont particulièrement rare. Un homme de 78 ans s'est présenté en consultation pour des douleurs pelviennes soulagées par la défécation ou les urines. Le toucher rectal retrouve une masse en avant de la paroi rectale antérieure. L'imagerie par résonance magnétique (IRM) montre une masse de 10 x 6 x 8cm, bien circonscrite et hétérogène, située en arrière de la vessie qu'elle refoule vers l'avant, en avant du recto-sigmoïde. L'immunohistochimie montre des cellules tumorales co-exprimant CD34 et la desmine de façon diffuse, expression de Rb dans la majorité des cellules, expression des récepteurs aux œstrogènes, expression intense et diffuse de la P16, un index de prolifération avec le ki67 estimé à 25%. Il n'y a pas eu de récidive après 8 mois de radiothérapie d'induction suivie de chirurgie. Un myofibroblastome de type mammaire est une tumeur rare et bénigne. La récidive n'est quasiment pas observée après traitement local. Ce cas permet de mettre en avance la possibilité d'utiliser la radiothérapie afin de faciliter la chirurgie.
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