Title: A Rare Case of Recurrent Malignant Phyllodes Tumor in Young Female

Author: Noor Elahi Pasha, Kshitij Kumar Singh, R.S. Meena

 DOI:  https://dx.doi.org/10.18535/jmscr/v5i7.223

Abstract

Phyllodes tumors are rare fibro epithelial lesions of the breast. Women of 5th decade are commonly involved. Phyllodes tumor can be benign, borderline and malignant. Recurrence is seen early in malignant tumors. Prompt preoperative cytological diagnosis is necessary for adequate surgical planning, reducing recurrence and subsequently reoperation. Preoperative differentiation between benign and malignant phyllodes is possible by cytology. Palpable lymph nodes, chest wall infiltration and distant metastasis are less frequent in malignant phyllodes tumors. Surgical management is the mainstay can be either wide local excision or mastectomy, but achieving histologically clear margins by surgery is crucial as local recurrence has been associated with inadequate local excision. Our report of similar case of recurrent malignant phyllodes tumor is to enlighten about the need of better surgical management and close follow up of the patients.

Keywords: phyllodes tumors, fibro epithelial lesions, mastectomy.

References

  1. Rowell MD, Perry RR, Jeng-Gwang H, Barranco SC. Phyllodestumors. Am J Surg 1993;165:376-9.  
  2. P. Rosen, Rosen’s Breast Pathology, Lippincott William Wikins, NewYork, NY, USA, 2nd edition,2001
  3. Muller J. Uber den feineranBau und die Forman der krankhaften Geschwilste. G Reimer 1838
  4. Bernstein, D. Deapen, and R. K. Ross, “The descriptive epidemiology of malignant cystosarcoma phyllodes tumors of thebreast, ”Cancer, vol.71, no.10, pp.3020–3024,1993.
  5. Ben Hassouna J, Damak T, Gamoudi A, Chargui R, Khomsi F, Mahjoub S, et al. Phyllodes tumors of the breast: A case series of 106 patients. Am J Surg 2006;192:141-7
  6. Popescu I, Serbanescu M, Ivaschescu C. Phyllodes tumors of the breast. Zentbl Chir., 1991;116:327–36.
  7. L.Chua, A. Thomas, B.K.Ng, “Cystosarcoma phyllodes: a review of surgical options,” Surgery, vol.105, no.2I,pp. 141– 147,1989
  8. G. Azzopardi, A. Ahmed, and R.R. Millis, “Problems in breast pathology,” Major Problems in Pathology, vol. 11, pp. 346–364, 1979
  9. Chaney AW, Pollack A, McNeese MD, Zagars GK, Pisters PW, Pollock RE, et al. Primary treatment of cystosarcoma phyllodes of the breast. Cancer 2000;89:1502-11. 
  10. Kapiris, N. Nasiri, R. A’Hern, V. Healy, and G. P. H. Gui, “Outcome and predictive factors of local recurrence and distant metastases following primary surgical treatment of high-grade malignant phyllodes tumors of the breast,” European Journal of Surgical Oncology, vol.27, no.8,pp.723–730,2001
  11. Stebbing JF, Nash AG. Diagnosis and management of phyllodes tumor of the breast: experience of 33 cases at a specialist centre. Ann R CollSurg Engl., 1995;77:181–4.
  12. Umpleby HC, Guyer PB, Moore I, et al. An evaluation of the preoperative diagnosis and management of cystosarcoma phyllodes. Ann R Coll Surg Engl., 1989;71:285
  13. Amerson JR. Cystosarcoma in adolescent females. Ann Surg., 1970;171:849–58.
  14. Komenaka, M. El-Tamer, E. Pile-Spellman, and H. Hibshoosh,“Core needle biopsy as a diagnostic tool to differentiate phyllodes tumor from fibroadenoma,” Archives of Surgery, vol. 138,no.9, pp.987–990,2003
  15. Cohn-Cedermark, L. E. Rutqvist, I. Rosendahl, and C. Silfversward, “Prog-nostic factors in cystosarcoma phyllodes: a clinicopathologic study of 77 patients,” Cancer, vol. 68, no. 9, pp.2017–2022,1991
  16. Tan PH, Thike AA, Tan WJ, Thu MM, Busmanis I, Li H, et al. Predicting clinical behaviour of breast phyllodestumors: A nomogram based on histological criteria and surgical margins. J Clin Pathol 2012; 65:69-76.

Corresponding Author

Noor Elahi Pasha

Post Graduate, Department of Surgery, GMC Kota

Email: This email address is being protected from spambots. You need JavaScript enabled to view it., Phone no: 7073081820