Breast malignant phyllodes tumour metastasising to soft tissues of oral cavity

Abstract

Metastases from infraclavicular neoplasms to the oral cavity are rare, and the anatomical structures most frequently affected are the maxillae. The primary sites that develop metastases to head and neck include lung, breast, liver, thyroid gland, kidney and melanomas, among others. The breast is one of the usual primary regions that can present them. In the literature, most metastases to these regions correspond to squamous cell carcinomas and adenocarcinomas; few studies report other type of neoplasms such as phyllodes tumour (PT) that present this behaviour. The importance of identifying metastatic disease to the oral cavity, be it as the first manifestation of a neoplasm from unknown origin or as a development in the course of the disease, is that it allows determination of adequate treatment, which has an effect on the patient's prognosis. The usual behaviour of PT is frequent recurrence and, when metastases are present, these are to lungs and bone. Two cases of malignant PT metastasising to tongue and lip are presented, as well as a review of the literature.

Distant Metastasis from Benign Phyllodes Tumor

“…After a wide excision of the upper lip mass, pathology report revealed spindle cell neoplasm which could be considered as a metastasis since phyllodes tumors do have spindle cell components and although rare, there have been 2 cases reported from Mexico of malignant phyllodes tumor metastasizing to soft tissues of the oral cavity namely, the tongue and lower lip. 2 However, confirmation to this effect via further review and/or immunohistochemistry could not be obtained.…”

Case Report: A 13-year-old adolescent diagnosed as malignant phyllodes tumor combined with rhabdomyosarcoma differentiation

“…Based on these findings, it was postulated that the possibility of a malignant phyllodes tumor (MPT) was considerable. Additionally, MPTs with a high expression level of Ki-67 (>50%) are more likely to exhibit distant metastasis ( 8 , 9 ). Considering the rapid recurrence following the previous operation and the high level of Ki-67 expression of the mass, the mastectomy procedure was conducted with the objective of ensuring a maximally negative margin, while the operation area was subjected to warm distilled water immersion to induce hypotonic lysis and subsequent death of tumor cells.…”