medigraphic.com
SPANISH

Ginecología y Obstetricia de México

Federación Mexicana de Ginecología y Obstetricia, A.C.
  • Contents
  • View Archive
  • Information
    • General Information        
    • Directory
  • Publish
    • Instructions for authors        
  • medigraphic.com
    • Home
    • Journals index            
    • Register / Login
  • Mi perfil

2022, Number 11

<< Back

Ginecol Obstet Mex 2022; 90 (11)

Bilateral phyllodes tumor, a rare form of clinical presentation: A case report

Santiago-Sanabria L, López-Valle MÁ, Garza-Arrieta J, Islas-Tezpa D
Full text How to cite this article

Language: Spanish
References: 24
Page: 933-941
PDF size: 343.89 Kb.


Key words:

Phyllodes tumor, Breast, Bilateral, Fibroepithelial lesion, Cystosarcoma phyllodes.

ABSTRACT

Background: The incidence of phyllodes tumors is 0.3% to 1% of all primary breast tumors. Their bilateral presentation may be synchronous or asynchronous and is exceptional. These tumors are classified (WHO) as fibroepithelial, benign, borderline or malignant. They appear in women with very wide age limits, although the most frequent is between 35 and 55 years of age. The definitive diagnosis is established based on the histopathological report. Treatment is surgical.
Clinical case: 50-year-old patient with obstetric history of two pregnancies and two cesarean sections. She came for consultation due to the appearance of a palpable mass in both breasts. She had no relevant history of breast cancer. Based on the mastography it was determined to be a BI-RADS 4A category tumor. The excisional biopsy, with trans-operative study, determined that it was a low-grade (benign) phyllodes tumor. Both tumors were excised, with sufficient free margins, in order to reduce the risk of recurrence. A follow-up plan was determined with annual mastography in which BI-RADS category 2 has been obtained. So far, the patient remains free of disease.
Conclusions: Phyllodes tumors are extremely rare and even more so their bilateral occurrence. It is important to integrate an early diagnosis and to perform a correct surgical procedure to avoid recurrences because they tend to be more and more aggressive. The indication of radiotherapy and chemotherapy in these tumors remains controversial and is only reserved as an alternative treatment for highly aggressive tumors.


REFERENCES

  1. Strode M, Khoury T, Mangieri C, Takabe K. Update on thediagnosis and management of malignant phyllodes tumorsof the breast. Breast 2017; 33: 91-96. doi:10.1016/j.breast.2017.03.001

  2. Pimiento JM, Gadgil P V, Santillan AA, et al. Phyllodestumors: Race-related differences. J Am Coll Surg 2011;213 (4): 537-42. doi:10.1016/j.jamcollsurg.2011.07.012

  3. Yılmaz S, Aykota MR, Arman Karakaya Y, Özgen U, ErdemE. Phyllodes Tumors of the Breast: A Single-Center Experience.Eur J Breast Heal 2021; 17 (1): 36-41. doi:10.4274/ejbh.2020.5961

  4. Bhasin S, Kumari S, Kumar V, Saini P, et al. Bilateral benigngiant phyllodes tumor in an adolescent female: a rare casereport. Int Surg J 2014; 1 (3): 177. doi:10.5455/2349-2902.isj20141115

  5. Trabelsi A. Synchronous bilateral benign phyllodes tumorof the breast in a 32-year-old Woman. World J Oncol 2010;1 (1): 45-46. doi:10.4021/wjon2010.01.1204

  6. Hayati F, Lian HH, Azizan N, Ali AA, et al. Approaches tophyllodes tumour of the breast: a review article. Int SurgJ 2017; 4 (3): 841. doi:10.18203/2349-2902.isj20170841

  7. Liuzzi S JF, Fernández A, Velásquez Y, Rincón N. Cistosarcomaphyllodes bilateral: Un raro caso. Rev VenezOncol 2010; 22 (3): 187-93. https://www.redalyc.org/pdf/3756/375634864004.pdf

  8. Norris HJ, Taylor HB. Relationship of Histologic Features T O.Cancer 1967: 2090-99. https://acsjournals.onlinelibrary.wiley.com/doi pdf/10.1002/1097-0142(196712)20:12%3C2090:AID-CNCR2820201206%3E3.0.CO;2-L

  9. Yuniandini A, Hamdani W, Prihantono P, Faruk M. Aretrospective review of phyllodes tumors of the breastfrom a single institution. Breast Dis 2021; 40 (S1): S63-S70.doi:10.3233/BD-219009

  10. Abdel Azim H, Abdel-Rahman O, Abdel-Malek R. Bilateralphyllodes tumor of the breast; a case report of benigntumor on one side and malignant tumor on the contralateralside. Res Oncol 2017; 13 (2): 56-58. doi:10.21608/resoncol.2017.356.1012

  11. Pietruszka M, Barnes L. Cystosarcoma phyllodes: a clinicopathologicalanalysis of 42 cases. Int Surg 1978; 64(5): 77-80.

  12. Mallory MA, Golshan M, Chikarmane SA, Raza S,Lester S, Caterson SA. Bilateral synchronous benignphyllodes tumors. Am Surg 2015; 81 (5): E192-EE194.doi:10.1177/000313481508100503

  13. Slodkowska E, Nofech-Mozes S, Xu B, et al. Fibroepitheliallesions of the breast: a comprehensive morphological andoutcome analysis of a large series. Mod Pathol 2018; 31(7): 1073-84. doi:10.1038/s41379-018-0032-8

  14. Rayzah M. Phyllodes Tumors of the Breast: A LiteratureReview. Cureus 2020; 12 (9). doi:10.7759/cureus.10288

  15. Fortarezza F, Pezzuto F, Cazzato G, et al. Bilateral phyllodesgiant tumor. A case report analyzed by array-CGH.Diagnostics 2020; 10 (10): 1-9. doi:10.3390/diagnostics10100825

  16. Shaaban M, Barthelmes L. Benign phyllodes tumours of thebreast: (Over) treatment of margins - A literature review.Eur J Surg Oncol 2017; 43 (7): 1186-90. doi:10.1016/j.ejso.2016.10.019

  17. Islam S, Maughn A, Bheem V, Harnarayan P, et al. World’sOldest Case of Synchronous Bilateral Benign PhyllodesTumors of the Breast: A Rare Occurrence. Cureus 2020;12 (12): 1-7. doi:10.7759/cureus.12281

  18. Zhang L, Yang C, Pfeifer JD, et al. Histopathologic, immunophenotypic,and proteomics characteristics of low-gradephyllodes tumor and fibroadenoma: more similarities thandifferences. NPJ Breast Cancer 2020; 6 (1). doi:10.1038/s41523-020-0169-8

  19. Seal SKF, Kuusk U, Lennox PA. Bilateral and multifocal phyllodestumours of the breast: A case report. Can J Plast Surg

  20. 2010; 18 (4): 145-46. doi:10.1177/22925503100180040320. Reich T SC. Bilateral cystosarcoma phyllodes, malignant variant,with 14-year follow-up; a case report. Ann Surg 1958;147 (1): 39-43. doi:10.1097/00000658-195801000-00006

  21. Notley R, Griffiths H. Bilateral malignant cystosarcomaphyllodes. Brit J Surg 1965; 52 (5): 360-62. doi:10.1002/bjs.1800520511

  22. Wiratkapun C, Piyapan P, Lertsithichai P, LarbcharoensubN. Fibroadenoma versus phyllodes tumor: Distinguishingfactors in patients diagnosed with fibroepithelial lesionsafter a core needle biopsy. Diagnostic Interv Radiol 2014;20 (1): 27-33. doi:10.5152/dir.2013.13133

  23. Shin GW, Park YM, Park JH, et al. Phyllodes tumour ofthe breast: Differentiation of histological grade by ultrasonography.Hong Kong J Radiol 2019; 22 (2): 107-113.doi:10.12809/hkjr1916906

  24. Tan PH, Thike AA, Tan WJ, et al. Predicting clinical behaviourof breast phyllodes tumours: A nomogram based on histologicalcriteria and surgical margins. J Clin Pathol 2012; 65(1): 69-76. doi:10.1136/jclinpath-2011-200368




2020     |     www.medigraphic.com

Mi perfil

C?MO CITAR (Vancouver)

Ginecol Obstet Mex. 2022;90