Malignant Phyllodes Tumour with Liposarcomatous Differentiation, Invasive Tubular Carcinoma, and Ductal and Lobular Carcinoma In Situ: Case Report and Review of the Literature

Abstract

A 43-year-old woman presented with a right breast lump that had enlarged over 5 months. She had chemoradiotherapy for non-Hodgkin's lymphoma in 1989. Histology revealed a malignant phyllodes tumour (PT) with liposarcomatous differentiation and ductal carcinoma in situ (DCIS) within the tumour with invasive tubular carcinoma, DCIS, and lobular carcinoma in situ in the surrounding breast. She had surgery and adjuvant radiotherapy. One year follow-up showed no recurrence or metastatic disease. Liposarcomatous differentiation is uncommon in PTs, and coexisting carcinoma is rare with 38 cases in 31 reports in the literature. Carcinoma is reported in malignant (n = 19), benign (n = 16) and in borderline PTs (n = 3) with invasive carcinoma (n = 18) and pure in situ carcinoma (n = 19) recorded in equal frequency. Carcinoma is more commonly found within the confines of benign PTs; whereas it is more often found surrounding the PT or in the contralateral breast in malignant PTs. Previous radiotherapy treatment is reported in only two cases. The aetiology of co-existing carcinoma is unclear but the rarity of previous radiotherapy treatment suggests that it is incidental. This case highlights the diverse pathology that can occur with PTs, which should be considered when evaluating pathology specimens as they may impact on patient management.

Invasive Cribriform Carcinoma Arising in Malignant Phyllodes Tumor of Breast: A Case Report

“…Of a total of 13 cases that have been reported up to present, 11 were followed up to monitor a clinical course. Nine patients survived with no evidence of disease progression during the follow-up period ranging from three months to nine years,3,4,6,8,11,12,14,15,17 and one patient died of the unrelated disease after a 9-year follow-up observation with no recurrence or metastasis 7. However, one patient experienced tumor recurrence.…”

Coexistence of malignant phyllodes tumor and her2-positive locally advanced breast cancer in distinct breasts: A case report

“…Although extremely rare, BC, either invasive or non-invasive, can be associated with PT: inside or outside of the PT; synchronously or metachronously; in the ipsilateral or other breast. Abdul Aziz et al summarized 39 cases of the coexistence of PT and BC in 2010 [2] , among which, coexisting PT and BC in distinct breasts occurred in only 7 cases and was even less common than being inside the PT (21 cases) or in the ipsilateral breast (16 cases; 5 cases were duplicated). Subsequently, we found three additional cases of the synchronous coexistence of PT and BC in distinct breasts [3] , [4] , [5] .…”

“…Phyllodes tumor of the breast (PT) is a rare biphasic neoplasm composed of epithelial and stromal elements, and accounts for less than 1% of all breast tumors [1] . Although even more uncommon, breast cancer (BC) can occur associated with PT: inside or outside of the PT; synchronously or metachronously; in the same breast or in distinct breasts [2] , [3] , [4] , [5] . We report here an extremely rare case of the synchronous coexistence of malignant PT and HER2-positive locally advanced BC in distinct breasts.…”

Case report: in situ ductal carcinoma arising in malignant phyllodes tumor

“…Farklı bir çalışmada 1974-2013 yılları arası İngiliz literatürü taranmış ve filloides tümörden kaynaklanan karsinom olgularının sayısının 40'ın altında olduğu tespit edilmiştir (6). Literatürde in situ lobüler karsinom, in situ duktal karsinom, invaziv lobüler karsinom, invaziv duktal karsinom, infiltratif karsinom ve skuamöz hücreli karsinom gelişen nadir filloides tümör olguları da mevcuttur (7)(8)(9). Filloides tümör karsinom birlikteliğinin oldukça nadir görülen bir durum olması bu olguların etiyoloji ve histopatolojik özelliklerinin aydınlatılabilmesini kısıtlamakta ve daha geniş serilerden oluşan çalışmalara ihtiyaç doğurmaktadır.…”