Metastatic cystosarcoma phyllodes: A case report and review of the literature

Abstract

The breast tumor cystosarcoma phyllodes probably does not Rpresent an entity, but rather a spectrum of disease including a benign form, a histologically malignant form, and a metastatic form. In an attempt to better understand the metastatic variant, all 66 cases which could be found in the english literature and an additional case from this institution were reviewed.The tumor often arises from a fibroadenoma, but its etiology is uncertain. Factors that determine the benignity or malignancy of the tumor are unknown, but a lower fertility rate in patients with metastases warrants interest.Incidence is low; cystosarcoma makes up about 0.5% of alI breast tumors and only 3-12% of these are metastatic.The tumor presents as a breast mass, often of large size, but there is no clinical feature peculiar to the metastatic variant.Gross and microscopic pathologic findings cannot accurately forecast the metastatic potential of the tumor, but are of more predictive value than the clinical presentation. The clinical course is the only sure means of determining metastatic potential at present.

Malignant Cystosarcoma Phyllodes: A Review of the Clinical Experience at King Faisal Specialist Hospital and Research Centre

“…14 Pain and ulceration are not considered as signs of malignancy. 2 All our patients presented with breast mass without ulceration. Axillary lymph node metastasis is exceedingly rare despite a large mass, a situation infrequent with adenocarcinoma.…”

“…2 Since early in this century, it has been recognized that the natural history and clinical behavior of this tumor are different from carcinoma of the breast. The mean age in larger series is in the fourth decade; 6,7 however, there are cases reported in the prepuberty and adolescent period.…”

“…1 It constitutes less than 1% of all malignant breast tumors. 2 It is a peculiar tumor that produces a spectrum of diseases ranging from benign, yet with the risk of local recurrence, to intermediate (borderline), to malignant, sometimes with a rapidly progressive course. Since it was originally described by Johannes Muller in 1838, 3 controversies concerning nomenclature, histologic interpretation, prediction of cytologic behavior and prognostic indices of this disease remain unresolved.…”

Malignant Phyllodes Tumor of the Breast: A Case Report

“…In a review of all reported cases of metastatic PT (67 cases) prior to 1972, Kessinger and colleagues [22] noted that the average survival time after diagnosis of metastasis was 30 months. Metastatic lesions have been reported as early as at the initial diagnosis of the primary tumor and as late as 12 years after diagnosis.…”

Effectiveness of MAID Therapy against Metastatic Malignant Phyllodes Tumors and Stromal Sarcoma of the Breast

“…Malignant phyllodes tumors (MPT) and stromal sarcoma of the breast are rare tumors, accounting for less than 1% of all breast tumors, and are frequently associated with distant metastases [1]. The tumors present with similar clinical features, and the most common sites of metastasis are the lungs, liver, bone and skin [2][3][4]. Metastasis to these sites often occurs in the absence of lymph node involvement [4,5].…”