Phyllodes tumor in a pediatric patient. Case report and literature revision

Daniel Orea-Estudillo; Lizbeth Jaimes-López; Jorge Bernal-Cano

2008, Number 2

<< Back Next >>

Cir Cir 2008; 76 (2)

Phyllodes tumor in a pediatric patient. Case report and literature revision

Orea-Estudillo D, Jaimes-López L, Bernal-Cano J

Full text

How to cite this article

Language: Spanish
References: 36
Page: 165-168
PDF size: 94.24 Kb.

ABSTRACT

Background: Phyllodes tumors have a frequency of 0.3-0.9% and are rare in young women. Their clinical presentation is unilateral and their behavior and management are unclear. We present a phyllodes tumor in an 11-year-old female and we reviewed the literature regarding this pathology.
Case report: We present the case of an 11-year-old female with a diagnosis of phyllodes tumor. Her disease began 4 months previously. We made an incision biopsy followed by a simple mastectomy. Histological report demonstrated benign phyllodes tumor. The patient is currently disease free after 1 year.
Conclusions: Small phyllodes tumors can be excised with a 1-cm surgical border, whereas larger phyllodes tumors are treated with simple mastectomy. Precise pathological evaluation is necessary to plan a better surgical approach and to determine recurrence possibility.

REFERENCES

1. Ben Hassouna J, Damak T, Gamoudi A, Chargui R, Khomsi F, Mahjoub S, et al. Phyllodes tumor of the breast: a case series of 106 patients. Am J Surg 2006;192:141-147.
2. Chen WH, Cheng SP, Tzen CY, Yang TL, Jeng KS, Liu CL. Surgical treatment of phyllodes tumor of the breast: retrospective review of 172 cases. J Surg Oncol 2005;1:185-194.
3. Müller J. Ueber den feinern Bau und die Formen der Krakhaften Geschwulste. (On the nature and structural characteristics of cancer). Berlin: G. Reimer, 1838. Translated by C. West, London: Sherwood, Gilbert, & Piper; 1840. pp. 54-57.
4. Lee BJ, Pack GT. Giant intracanalicular fibroadenomyxoma of the breast: the so-called cystosarcoma phyllodes mammae of Johannes Müller. Am J Cancer 1931;15:2583-2609.
5. Bhagat G, Leffler D, Leffler D, Bilezikian JP, Green PH. Cystosarcoma phyllodes of the breast occurring in a child with subsequent diagnosis of celiac disease. J Pediatr Gastroenterol Nutr 2003;36:644-646.
6. Martino A, Zamperelli M, Santinelli A, Cobellis G, Rossi L, Amici G. Unusual clinical presentation of a rare case of phyllodes tumor of the breast in an adolescent girl. J Pediatr Surg 2001;36:941-943.
7. Salazade M, Gidener C, Koyuncuoglu M, Mevsim A. Borderline phyllodes tumor in an 11-year-old girl. Pediatr Surg 1999;15:427-428.
8. Rajan PB, Cranor ML, Rosen PP. Cystosarcoma phyllodes in adolescent girls and young women: a study of 45 patients. Am J Surg Pathol 1998;22:64-69.
9. Corpron CA, Black CT, Singletary SE, Andrassy RJ. Breast cancer in adolescent females. J Pediatr Surg 1995;30:322-324.
10. Leveque J, Meunier B, Wattier E, Burtin F, Grall JY, Kerisit J. Malignant cystosarcomas phyllodes of the breast in adolescent females. Eur J Obstet Gynecol Reprod Biol 1994;18:197-203.
11. Fou A, Schnabel FR, Hamele-Bena D, Wei XJ, Cheng B, El Tamer M, et al. Long-term outcomes of malignant phyllodes tumor patients: an institutional experience. Am J Surg 2006;192:492-495.
12. Lifshitz OH, Whitman GJ, Sahin AA, Yang WT. Radiologic-pathologic conference of the University of Texas MD Anderson Cancer Center: phyllodes tumor of the breast. Am J Roentgenol 2003;180:332-335.
13. Parker SJ, Harries SA. Phyllodes tumours. Postgrad Med J 2001;77:428-435.
14. Barth RJ. Histologic features predict local recurrence after breast conserving therapy of phyllodes tumors. Breast Cancer Res Treat 1999;57:291-295.
15. Chan YJ, Chen BF, Chang CL, Yang TL, Fan CC. Expression of p53 protein and Ki-67 antigen in phyllodes tumor of the breast. J Chin Med Assoc 2004;67:3-8.
16. Dacic S, Kounelis S, Kouri E, Jones MW. Immunohistochemical profile of cystosarcoma phyllodes of the breast. Breast J 2002;8:376-381.
17. Feakins RM, Mulcahy HE, Nickols CD, Wells CA. p53 expression in phyllodes tumours is associated with histological features of malignancy but does not predict outcome. Histopathology 1999;35:162-169.
18. Kleer CG, Giordano TJ, Braun T, Oberman HA. Pathologic, immunohistochemical and molecular features of benign and malignant phyllodes tumors of the breast. Mod Pathol 2001;14:185-190.
19. Kuenen BV, Henzen SC, Timmermans MM. Altered expression of p53 and its regulated proteins in phyllodes tumours of the breast. J Pathol 1999;189:169-175.
20. Millar EK, Beretov J, Marr P, et al. Malignant phyllodes tumours of the breast display increased stromal p53 protein expression. Histopathology 1999;34:491-496.
21. Niezabitowski A, Lackowska B, Rys J. Prognostic evaluation of proliferative activity and DNA content in the phyllodes tumor of the breast: immunohistochemical and flow cytometric study of 188 cases. Breast Cancer Res Treat 2001;65:77-85.
22. Sawyer EJ, Poulsom R, Hunt FT. Malignant phyllodes tumours show stromal overexpression of c-myc and c-kit. J Pathol 2003;200:59-64.
23. Shpitz B, Bomstein Y, Sternberg A. Immunoreactivity of p53, ki-67 and c-erbB-2 in phyllodes tumors of the breast in correlation with clinical and morphologic features. J Surg Oncol 2002;79:86-92.
24. Sou Z, Nesland JM. Phyllodes tumor of the breast: EGFR family expression and relation to clinicopathological features. Ultrastruct Pathol 2000;24:371-381.
25. Tse GM, Lui PC, Scolyer RA. Tumour angiogenesis and p53 protein expression in mammary phyllodes tumor. Mod Pathol 2003;16:1007-1013.
26. Tse GM, Putti TC, Kung FY. Increased p53 protein expression in malignant mammary phyllodes tumor. Mod Pathol 2002;15:734-740.
27. Tse GM, Putti TC, Lui PC. Increased c-kit (CD117) expression in malignant mammary phyllodes tumor. Mod Pathol 2004;17:827-831.
28. Witte F, Honig A, Mirecka J, Schauer A. Cystosarcoma phyllodes of the breast: prognostic significance of proliferation and apoptosis associated genes. Anticancer Res 1999;19:3355-3359.
29. Chen CM, Chen CJ, Chang CL. CD34, CD 117 and actin expression in phyllodes tumor of the breast. J Surg Res 2000;94:84-91.
30. Khan SA, Badve S. Phyllodes tumors of the breast. Curr Treat Options Oncol 2001;2:139-147.
31. Joshi SC, Sharma DN, Bahadur AK. Cystosarcoma phyllodes: our institutional experience. Australas Radiol 2003;47:434-437.
32. Deeming G. Divakaran R, Butterworth D, Foster M. Temporomandibular region metastasis from cystosarcoma phyllodes: a case report and review of the literature. J Craniomaxillofac Surg 2003;31:325-328.
33. Guerrero MA, Ballard BR, Grau AM. Malignant phyllodes tumor of the breast: review of the literature and case report of stromal overgrowth. Surg Oncol 2003;12:27-29.
34. Singletary E. Tumor Oncology Series. New York: Springer;1999. pp. 273-283.
35. Sanchez BC. Compendio de patología mamaria. JGH Editores;1999. pp. 305-307.
36. Nicosia N, Mohan D, Brafky A. Phyllodes tumor; a clinicopathologic and immunohistochemical study of 30 cases. Arch Pathol Lab Med 2006;130:1516-1521.