Malignant phyllodes tumor of the breast in a young patient –case report
DOI:
https://doi.org/10.29289/2594539420220043%20Palavras-chave:
phyllodes tumor, malignant phyllodes tumor, breast neoplasm, case reportsResumo
Phyllodes tumor (PT) is an uncommon form of breast tumor. It occurs most commonly in women aged 35 to 65 years. The benign form represents about 85–90% of cases and only 10–15% of PTs are malignant. Clinically and radiologically, malignant phyllodes tumor (MPT) presents as regular, well-delimited, mobile nodules that are difficult to distinguish from fibroadenomas of the breast. The most important differential diagnoses of MPT include fibroadenoma, metaplastic carcinoma, and sarcoma. The prognosis of MPT exhibits a higher frequency of local recurrence and metastatic rate with larger tumors and inadequate surgical margins. The case presented here refers to a 24-year-old female patient, with a vast tumor in the right breast, with rapid and progressive growth, associated to local pain, and histological diagnosis of MPT. Surgery was the initial treatment, followed by adjuvant chemotherapy and radiotherapy. The purpose of this article was to report an atypical case of MPT of the breast in a very young woman as well as to make a brief literature review on this infrequent and dangerous disease.
Downloads
Referências
1. Abe H, Teramoto A, Takei Y, Tanaka Y, Yoneda G. Malignant phyllodes tumor of the breast with rapid progression: a case report. Surg Case Rep. 2020;6(1):308. https://doi.org/10.1186/s40792-020-00986-8
2. Costa REAR, Barros LFRB, Silva Júnior RGS, Negreiros MAV, Coelho EG, Moreira Junior AL, et al. Tumor Filóide maligno de mama: relato de caso. Rev Bras Cancerol. 2022;68(3):e-012568. https://doi.org/10.32635/2176-9745.RBC.2022v68n3.2568
3. Lissidini G, Mulè A, Santoro A, Papa G, Nicosia L, Cassano E, et al. Malignant phyllodes tumor of the breast: a systematic review. Pathologica. 2022;114(2):111-20. https://doi.org/10.32074/1591-951X-754
4. Lombardi W, Roncatti BM, Mariano EM, Butignoli Junior G, Coleto ICLD, Mouro M, et al. Tumor phyllodes de mama com componente epitelial maligno em paciente de 22 anos. Relatos Casos Cir. 2019;(3):e2230. https://doi.org/10.30928/2527-2039e-20192230
5. Wu H, Li L, Yang J, Guo C, Zhang W, Wang H. Radiotherapy with apatinib for recurrence of malignant phyllodes tumor of the breast: a case report. Medicine (Baltimore). 2020;99(3):e18808. https://doi.org/10.1097/MD.0000000000018808
6. Koukourakis IM, Zygogianni A, Kouloulias V, Koukourakis MI. Successful treatment of recurrent and metastatic malignant phyllodes tumor with accelerated radiotherapy and Nab-paclitaxel, cisplatin, and lipossomal doxorrubicin chemotherapy. Chemotherapy. 2021;66(3):82-6. https://doi.org/10.1159/000517246
7. Papas Y, El Asmar A, Ghandour F, Hajj I. Malignant phyllodes tumors of the breast: a comprehensive literature review. Breast J. 2020;26(2):240-4. https://doi.org/10.1111/tbj.13523
8. Mustață L, Gică N, Botezatu R, Chirculescu R, Gică C, Peltecu G, et al. Malignant phyllodes tumor of the breast and pregnancy: a rare case report and literature review. Medicina (Kaunas). 2021;26;58(1):36. https://doi.org/10.3390/medicina58010036
9. Jacklin RK, Ridgway PF, Ziprin P, Healy V, Hadjiminas D, Darzi A. Optimising preoperative diagnosis in phyllodes tumour of the breast. J Clin Pathol. 2006;59(5):454-9. https://doi.org/10.1136/jcp.2005.025866
10. Maritz RM, Michelow PM. Cytological criteria to distinguish phyllodes tumour of the breast from fibroadenoma. Acta Cytol. 2017;61(6):418-24. https://doi.org/10.1159/000477573
11. Karim RZ, Gerega SK, Yang YH, Spillane A, Carmalt H, Scolyer RA, et al. p16 and pRb immunohistochemical expression increases with increasing tumour grade in mammary phyllodes tumours. Histopathology. 2010;56(7):868-75. https://doi.org/10.1111/j.1365-2559.2010.03562.x
12. Kapiris I, Nasiri N, A’Hern R, Healy V, Gui GP. Outcome and predictive factors of local recurrence and distant metastases following primary surgical treatment of high-grade malignant phyllodes tumours of the breast. Eur J Surg Oncol. 2001;27(8):723-30. https://doi.org/10.1053/ejso.2001.1207
13. Asoglu O, Ugurlu MM, Blanchard K, Grant CS, Reynolds C, Cha SS, et al. Risk factors for recurrence and death after primary surgical treatment of malignant phyllodes tumors. Ann Surg Oncol. 2004;11(11):1011-7. https://doi.org/10.1245/ASO.2004.02.001
14. National Comprehensive Cancer Network. NCCN Guidelines. Breast Cancer [Internet]. [cited on 2022 Nov 3]. Available from: https://www.nccn.org/guidelines/guidelines-detail?category=1&id=1419
15. Rowell MD, Perry RR, Hsiu JC, Barranco SC. Phyllodes tumors. Am J Surg. 1993;165(3):376-9. https://doi.org/10.1016/s0002-9610(05)80849-9
16. Belkacémi Y, Bousquet G, Marsiglia H, Ray-Coquard, I, Magné N, Malard Y, et al. Phyllodes tumor of the breast. Int J Radiat Oncol Biol Phys. 2008;70(2):492-500. https://doi.org/10.1016/j.ijrobp.2007.06.059
17. Strode M, Khoury T, Mangieri C, Takabe K. Update on the diagnosis and management of malignant phyllodes tumors of the breast. Breast. 2017;33:91-6. https://doi.org/10.1016/j.breast.2017.03.001
18. Tse GMK, Lee CS, Kung FYL, Scolyer RA, Law BK, Lau T, et al. Hormonal receptors expression in epithelial cells of mammary phyllodes tumors correlates with pathologic grade of the tumor: a multicenter study of 143 cases. Am J Clin Pathol. 2002;118(4):522-6. https://doi.org/10.1309/D206-DLF8-WDNC-XJ8K
19. Rosenberger LH, Thomas SM, Nimbkar SN, Hieken TJ, Ludwig KK, Jacobs LK, et al. Germline genetic mutations in a multi-center contemporary cohort of 550 phyllodes tumors: an opportunity for expanded multi-gene panel testing. Ann Surg Oncol. 2020;27(10):3633-40. https://doi.org/10.1245/s10434-020-08480-z
Downloads
Publicado
Como Citar
Edição
Seção
Licença
Copyright (c) 2024 Cássio Furtini Haddad, Ana Carolina de Oliveira Paiva, Juan Pablo de Souza Silva, Isabela Teixeira Rodrigues
Este trabalho está licenciado sob uma licença Creative Commons Attribution 4.0 International License.
