Cystosarcoma Phyllodes in Adolescent Females

Amerson, J R

doi:10.1097/00000658-197006010-00005

Cited by 48 publications

(21 citation statements)

References 7 publications

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“…Patient age does not appear to be important10 27 56 67 but tumours presenting in adolescence do seem to be less aggressive irrespective of their histological type 1314 30 The role of tumour size is unclear.…”

Section: Prognostic Factorsmentioning

confidence: 99%

Phyllodes tumours

Parker

Harries

2001

Postgraduate Medical Journal

296

345

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Phyllodes tumours are rare fibroepithelial lesions that account for less than 1% of all breast neoplasms. With the non-operative management of fibroadenomas widely adopted, the importance of phyllodes tumours today lies in the need to diVerentiate them from other benign breast lesions. All breast lumps should be triple assessed and the diagnosis of a phyllodes tumour considered in women, particularly over the age of 35 years, who present with a rapidly growing "benign" breast lump. Treatment can be by either wide excision or mastectomy provided histologically clear specimen margins are ensured. Nodal metastases are rare and routine axillary dissection is not recommended. Few reliable clinical and histological prognostic factors have been identified. Local recurrence occurs in approximately 15% of patients and is more common after incomplete excision. It can usually be controlled by further surgery. Repeated local recurrence has been reported without the development of distant metastases or reduced survival. Approximately 20% of patients with malignant phyllodes tumours develop distant metastases. Long term survival with distant metastases is rare. The role of chemotherapy, radiotherapy, and hormonal manipulation in both the adjuvant and palliative settings remain to be defined. (Postgrad Med J 2001;77:428-435)

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Section: Prognostic Factorsmentioning

confidence: 99%

Phyllodes tumours

Parker

Harries

2001

Postgraduate Medical Journal

296

345

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“…The mean age in larger series is in the fourth decade; 6,7 however, there are cases reported in the prepuberty and adolescent period. 8,9 The median age in our series is 45 years, while our youngest patient was 16 years old. One of the salient features of cystosarcoma phyllodes is the very rare occurrence in men due to lack of a lobular-alveolar unit in the male breast.…”

Section: Discussionmentioning

confidence: 70%

Malignant Cystosarcoma Phyllodes: A Review of the Clinical Experience at King Faisal Specialist Hospital and Research Centre

Ezzat

Abdulkareem²,

El-Senoussi³

et al. 1994

Annals of Saudi Medicine

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Twelve females with cystosarcoma phyllodes of the breast were referred to King Faisal Specialist Hospital and Research Centre (KFSH&RC) between 1980 and 1990, representing 0.8% of breast cancer patients seen during this period. Median age was 45 years (range 16 to 65 years). Seven patients (58%) were premenopausal. All patients presented with breast mass, which measured >10 cm in 58% of them. The median duration of symptoms was 15 months (range two to 174). Neither axillary lymph nodes nor distant metastases were seen at presentation. Surgery was the cornerstone of primary treatment (wide local excision in three and mastectomy in nine). Two patients received adjuvant chemotherapy and locoregional irradiation. All patients had malignant tumors histologically. Of the four tumors assayed for hormonal receptors, one was positive for estrogen and progesterone receptors. At a median follow-up of 17 months (range two to 77), four patients had relapsed; one died at 19 months and the projected five year survival is 83%. This limited data supports the observation that malignant cystosarcoma phyllodes is a distinctive clinicopathological entity of female breast cancer with a different natural history from carcinoma of the breast. Our survival results are similar to reported experience from the literature.

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“…Of 20 adolescent cases in the American literature, only one follow-up death was attributed to a malignant cystosarcoma in a 14-year-old female. 6 The sonographic characteristics of the three cases of giant fibroadenoma described here include: (1) a large mass with well-defined margins; (2) relatively homogenous internal echoes; and (3) varying degrees of enhanced through transmission of sound. Unfortunately, the sonographic appearance of giant fibroadenoma and cystosarcoma overlap, but the presence of fluid-filled cysts or clefts in an otherwise solid lesion would suggest cystosar~oma.~ A pre-excision wedge biopsy and possibly more extensive resection as suggested by Haagensen could then be p e r f~r m e d .~ Sonography may also be helpful in the detection of multiple masses preoperatively, thus avoiding the possibility of a second breast operation in a young patient.…”

Section: Discussionmentioning

confidence: 97%