Phyllodes Tumours: A Clinicopathological Review of 30 Cases

Abstract

Thirty cases of phyllodes tumour (cystosarcoma phyllodes) of the breast that presented to the Clinical Oncology Unit at Guy's Hospital were reviewed. Tumours were classified as benign, malignant or borderline according to the following histological criteria: mitotic rate, nuclear pleomorphism, stromal overgrowth and tumour margins. In 14 (46.5%) cases the tumours were considered histologically benign, in 11 (36.5%) malignant, and in five (17%) borderline. Recurrence was seen in a similar proportion of patients with tumours classified as benign (21 %) and malignant (18 %) according to histological criteria. Malignant lesions tended to recur earlier. Infiltrating tumour margins were noted in all patients and stromal overgrowth in all hut one in whom recurrence was observed. Risk of recurrence also appeared to he related to tumour size. Only one patient developed distant metastases and died of her disease. Because of treatment variation no conclusion can he made regarding optimal therapy but the importance of adequate clearance, either through wide excision or mastectomy, is emphasized for all phyllodes tumours irrespective of histological features.

Primary treatment of cystosarcoma phyllodes of the breast

“…19 The proportion of patients with benign, indeterminate, and malignant disease in this study differs from some reports, 2,10,15 but compare well with other studies in the literature. 1,4,9 Some authors believe that borderline tumors behave similarly to malignant lesions. 9 In the current series only 12 patients had indeterminate tumors; these behaved in a less aggressive fashion and were grouped with benign tumors.…”

“…Local C ystosarcoma phyllodes is an uncommon fibroepithelial breast neoplasm that accounts for 0.5-1.0% of female breast carcinoma cases. [1][2][3][4] These tumors can occur in women of all ages, including adolescents and the elderly. [5][6][7][8][9] The majority arise in women between ages 35-55 years.…”

Gravidez e Tumor Filodes Bilateral: Uma Associação Rara

“…Como estes tumores, muitas vezes, já se apresentam grandes no momento do diagnóstico, o tratamento pode, embora raramente, culminar com uma mastectomia. Não há necessidade de linfadenectomia axilar, pois raramente os linfonodos estão comprometidos 1,2,8,9 . As recidivas locais usualmente indicam excisão inicial inadequada, sendo necessária nova intervenção cirúrgica para remoção das áreas de recorrência 1 .…”

“…Não há necessidade de linfadenectomia axilar, pois raramente os linfonodos estão comprometidos 1,2,8,9 . As recidivas locais usualmente indicam excisão inicial inadequada, sendo necessária nova intervenção cirúrgica para remoção das áreas de recorrência 1 . O presente relato mostra um caso raro de tumor filodes bilateral na gestação, que apresentou crescimento rápido, influenciado pela hiperplasia fisiológica da gravidez, culminando com mastectomia total bilateral e apresentando resultado terapêutico satisfatório.…”

“…Relato de Caso 21 (2): 109-111, 1999 RBGO Introdução O tumor filodes, também denominado cystosarcoma phyllodes em razão das projeções foliácias de tecido tumoral no interior de cavidades císticas, é uma neoplasia mista de tecido epitelial e conectivo, caracterizando-se por um crescimento rápido e podendo apresentar grandes dimensões no momento do diagnóstico 1,3,7,8,9 . É um tumor raro, representando 0,5% de todos tumores mamários.…”