Huge borderline phyllodes breast tumor with repeated recurrences and progression toward more malignant phenotype: a case report and literature review

Zhang, Yonglin; Chen, Guanglei; Liu, Fangming; Liu, Chao; Xu, Ting; Ma, Zhigui

doi:10.2147/ott.s171714

Cited by 12 publications

(27 citation statements)

References 29 publications

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“…In this study, the mean time to recurrence after VAB was 7.8 months (1–12 months). Previous studies showed the average interval to recurrence of benign PT was two years after the treatment with surgical resection [ [18] , [19] , [20] , [21] ]. The recurrence time after VAB was shorter in this study than in previous studies, which might be explained by the fact that a small amount of residual cells after VAB could not be detected on US, resulting in early recurrence.…”

Section: Discussionmentioning

confidence: 99%

Ultrasound-guided vacuum-assisted excisional biopsy to treat benign phyllodes tumors

Shang

Zhang

et al. 2020

The Breast

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Purpose To evaluate the value of ultrasound (US)-guided vacuum-assisted excisional biopsy (VAB) in treating benign phyllodes tumors (PTs) of the breasts and to investigate the lesion characteristics that could affect the local recurrence rate. Patient and methods From December 2008 to February 2018, 93 patients with PTs diagnosed on histology underwent US-guided, 7-gauge VAB. The recurrence rate of benign PT and complications of VAB were evaluated on follow-up US every three to six months. The lesion characteristics were analyzed to identify the factors affecting the recurrence rate. Results Of the 87 patients, local recurrence was found in 15 patients (17%) in a mean follow-up period of 35.8 months, and the rate of complete excision was 82.8% (72/87). PTs with a largest diameter less than 3.3 cm had a significantly lower recurrence rate than PTs with a largest diameter larger than 3.3 cm (P < 0.05). Conclusions In conclusion, US-guided VAB is an effective method to treat benign PT, especially in lesions with a diameter less than 3.3 cm.

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Section: Discussionmentioning

confidence: 99%

Ultrasound-guided vacuum-assisted excisional biopsy to treat benign phyllodes tumors

Shang

Zhang

et al. 2020

The Breast

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“…However, recent research has revealed that the survival after mastectomy and wide local excision with postoperative radiotherapy was equivalent[ 12 ]. Consequently, conservative surgery is recommended, but mastectomy should be carried out according to the following reasons: Benign or borderline tumours at least 8 cm in size, malignant PTs, or positive margins[ 13 ]. Margins of at least 1 cm with wide local excision were recommended by the National Comprehensive Cancer Network guideline for each PT grade.…”

Section: Discussionmentioning

confidence: 99%

Giant benign phyllodes breast tumour with pulmonary nodule mimicking malignancy: A case report

Zhang¹,

Feng²,

Lian³

et al. 2020

WJCC

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BACKGROUND Phyllodes tumours (PTs) are fibroepithelial breast tumours, which can be classified as benign, borderline or malignant, according to their histological characteristics. While various huge borderline or malignant PTs have been previously described, a benign PT with a pulmonary nodule mimicking malignancy has not yet been reported. In order that doctors may have a comprehensive understanding of super-giant benign PTs (≥ 20 cm), we also performed a literature review to summarize the clinical features, differential diagnosis, and treatment of this disease. CASE SUMMARY A 42-year-old woman with severe anaemia presented with a rapidly enlarging right breast mass, measuring approximately 30 cm × 25 cm × 20 cm that was first noticed 1 year previously. A region of skin ulceration and necrosis (20 cm × 15 cm) was observed on the lateral side of the mass. Computed tomography (CT) of the chest revealed a pulmonary nodule, which initially suggested a diagnosis of metastasis. CT showed that the boundaries between the pectoralis major and the mass were blurred, which was presumed to be due to tumour invasion. However, two core needle biopsies of the mass showed no evidence of malignancy. Following these results, the tumour was removed by mastectomy of the right breast. Interestingly, postoperative pathology finally proved the diagnosis of a benign PT. After 1 year of follow-up, wedge resection of the small pulmonary nodule was performed, and it was confirmed that the lung nodule was actually adenocarcinoma rather than metastatic breast cancer. The patient recovered very well without any postoperative treatment. CONCLUSION This case is unique in that the giant breast mass initially mimicking a malignant clinical presentation was eventually pathologically confirmed to be a benign PT, which misled the diagnosis and complemented the atypical features of benign PTs. The pathological and immunohistochemical results were important in the differential diagnosis. In addition, total mastectomy should be recommended due to difficulty in the precise diagnosis of PTs, especially in large breast masses. In the literature, almost one-half of super-giant benign cases were thought to be malignant tumours before surgery. This finding is a reminder to consider all conditions in order to make an accurate diagnosis and avoid excessive treatment.

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“…Its name derives from the Greek phyllon (leaf) because of its lobed histological appearance. It is also known as cystosarcoma phyllodes, adenomatous myxoma and pseudosarcoma adenoma [[1], [2], [3]]. PTs are common in middle-aged women, with an average size of 4–7 cm and rapid growth [1,3,4].…”

Section: Introductionmentioning

confidence: 99%

“…It is also known as cystosarcoma phyllodes, adenomatous myxoma and pseudosarcoma adenoma [[1], [2], [3]]. PTs are common in middle-aged women, with an average size of 4–7 cm and rapid growth [1,3,4]. They are fibroepithelial tumors, composed of stromal and epithelial elements, differing from fibroadenomas (FA) by the greater abundance of the stromal component [3].…”

Section: Introductionmentioning

confidence: 99%

“…PTs are common in middle-aged women, with an average size of 4–7 cm and rapid growth [1,3,4]. They are fibroepithelial tumors, composed of stromal and epithelial elements, differing from fibroadenomas (FA) by the greater abundance of the stromal component [3]. Because of local recurrence and metastatic potential, they are surgically treated with wide local excision and mastectomy [[2], [3], [4], [5]].…”

Section: Introductionmentioning

confidence: 99%

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Recurrent borderline phyllodes tumor of the breast submitted to mastectomy and immediate reconstruction: Case report

Garlet

Zogbi

Lima

et al. 2019

International Journal of Surgery Case Reports

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Highlights Phyllodes tumors of the breast are rare fibroepithelial neoplasms. They are histologically classified into benign, borderline and malignant variants. Anatomopathological examination is considered the definitive diagnostic method. They have a high rate of local recurrence and the possibility of metastases. Surgery is the definitive treatment and adjuvant therapy is controversial.

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Huge borderline phyllodes breast tumor with repeated recurrences and progression toward more malignant phenotype: a case report and literature review

Cited by 12 publications

References 29 publications

Ultrasound-guided vacuum-assisted excisional biopsy to treat benign phyllodes tumors

Ultrasound-guided vacuum-assisted excisional biopsy to treat benign phyllodes tumors

Giant benign phyllodes breast tumour with pulmonary nodule mimicking malignancy: A case report

Recurrent borderline phyllodes tumor of the breast submitted to mastectomy and immediate reconstruction: Case report

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