Malignant phyllodes tumor with pleomorphic liposarcomatous stroma in the breast

Abstract

Background: Malignant phyllodes tumor with pleomorphic liposarcomatous stroma is rare, accounting for less than 1% of all breast tumors and only 2–3% of mammary fibroepithelial neoplasms. These tumors are initially identified as small, palpable mass, the quickly development make them clinically evident. The definitive diagnosis should be determined by histological exam which morphological characteristics are size, tumor margin, and relative lack of an epithelial component as well as mitotic count. Case report: A 20-year old female was admitted in October 2005 in Santa Casa de Belo Horizonte hospital. She revealed a large palpable mass in the left breast. The lesion had been noticed previously and had rapidly enlarged. The patient had no family history of breast cancer. Clinical examination revealed a solid mass, fixed to deep tissue mass in the entire breast, without skin lesion and no palpable axillary and subclavicular lymph nodes. She was submitted to a surgical resection of the lesion which showed a yellow color, solid consistence and without necrosis area. Histological examination revealed malignant phyllodes tumor with pleomorphic liposarcomatous stroma. She was submitted to nine surgical interventions in order to resect recurrent tumors and associated chemotherapy. Conclusion: The recent diagnosis of malignant phyllodes tumor with pleomorphic liposarcomatous stroma is very important to the planning treatment. It is also necessary to observe patients over long periods for possible recurrence and metastasis after surgery for this tumor. The histological diagnosis should be carefully done in order to distinguish malignant phyllodes tumor with pleomorphic liposarcomatous stroma from other tumors such as fibroadenoma and primary liposarcoma.