Huge borderline phyllodes breast tumor with repeated recurrences and progression toward more malignant phenotype: a case report and literature review
Authors Wang Y, Zhang Y, Chen G, Liu F, Liu C, Xu T, Ma Z
Received 20 April 2018
Accepted for publication 10 September 2018
Published 2 November 2018 Volume 2018:11 Pages 7787—7793
Checked for plagiarism Yes
Review by Single-blind
Peer reviewer comments 3
Editor who approved publication: Dr William Cho
Yining Wang,* Yonglin Zhang,* Guanglei Chen, Fangming Liu, Chao Liu, Tiantian Xu, Zhenhai Ma
Department of Breast Disease and Reconstruction Center, Breast Cancer Key Lab of Dalian, The Second Affiliated Hospital of Dalian Medical University, Dalian, Liaoning 116027, China
*These authors contributed equally to this work
Background: Phyllodes tumor (PT) is a rare breast fibroepithelial biphasic tumor composed of stromal and epithelial components. The patients suffering from this disease present with a large, round, mobile, fast-growing lump, and the giant PT of more than 10 cm in diameter is so uncommon. Surgery is regarded as the primary treatment, but curative efficiency of adjuvant chemotherapy and radiotherapy is so indefinite.
Case presentation: We reported one case of a middle-aged woman with a huge borderline PT in the right breast, over 20 cm in size. The pathology of needle core biopsy of the lump was suggestive of PT of the borderline subgroup, and then she underwent mastectomy of the right breast. The patient had recovered well without any postoperative treatment until a local recurrence occurred 1 year after operation. The tumor was removed with lumpectomy, which was pathologically diagnosed as malignant PT. We followed up her by telephone and heard about her postoperative adjuvant radiotherapy and chemotherapy, as well as her well recovery.
Conclusion: The pathology of PT with low incidence is mostly benign, but local recurrence is common, and the histopathology progresses toward worsen trend. Besides, due to the difficulty in precise diagnosis of the borderline PTs, it is recommended that this subtype of patients should undergo total mastectomy. Although the curative effect of postoperative treatment has not been recognized internationally, patients, especially those with huge tumors, may benefit from these treatments.
Keywords: phyllodes tumor, breast neoplasms, recurrence, diagnosis, treatment
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