Phyllodes Tumor of the Breast With Malignant Melanoma Component

ZusammenfassungDer Mamillen-Areola-Komplex ist Ausgangspunkt verschiedener morphologisch eigenständiger Tumoren und tumorartiger Veränderungen, die sich von den besonderen Strukturen der Mamille, insbesondere den intramamillären Milchgängen, den Anhangsgebilden und dem intramamillären Stroma ableiten lassen. Im Vordergrund stehen dabei epitheliale Tumoren gutartigen Verhaltens wie das Mamillenadenom und der syringomatöse Tumor der Mamille. Seltener sind benigne mesenchymale Tumoren wie das Leiomyom der Mamille und tumorartige Veränderungen wie das Pseudolymphom der Mamillenregion. Bei den Überschussbildungen der Mamille sind die verschiedenen Formen der Polythelie und der Polymastie zu berücksichtigen.

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Pathologie der Mamillenregion

Gutjahr

Streng

Aulmann

et al. 2020

Pathologe

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Expression of EMT markers and mode of surgery are prognostic in phyllodes tumors of the breast

et al. 2017

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Phyllodes tumors of the breast are rare neoplasms that account for <1% of all mammary tumors and 2-3% of fibro-epithelial neoplasms of the breast. We evaluated the clinicopathological characteristics of a cohort of 246 Chinese patients in relation to the expression of epithelial-to-mesenchymal (EMT) markers in benign, borderline and malignant tumors and the prognostic value of different surgical regimens. We observed that survival outcomes correlated with the mode of surgical management in the three patient groups. Expression of E-cadherin, Snail, Slug and Twist were higher in epithelial cells from borderline and malignant tumors than those in benign tumors, whereas the expression of N-cadherin was opposite. Levels of the EMT markers Snail and Slug in the stromal compartment increased with the advancing tumor grade. Expression of mesenchymal stem cell markers contributed to the inherent heterogeneity in the malignant tumors. Based on Cox models, surgical management emerged as an independent predictor for disease-free survival, whereas a history of recent growth and tumor grade were independent predictors for overall survival. These findings show that expression of EMT markers, the mode of surgical management, and a history of recent tumor growth had prognostic potential for patients with phyllodes tumors of the breast.

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

Lian,

Gao,

Yao

et al. 2023

Front. Oncol.

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Phyllodes tumor (PT) is an infrequent type of breast neoplasm, constituting a mere 0.5%–1.5% of the entirety of breast tumors. The malignant phyllodes tumor (MPT) comprises only 15% of all phyllodes tumors, and its transformation into rhabdomyosarcoma (RMS) is exceedingly rare in clinical practice. Given its insensitivity to chemotherapy and radiotherapy, treatment options for MPT patients are limited, leaving complete surgical resection as the only option. Therefore, it is imperative to investigate the effective utilization of the heterogeneous differentiation characteristics of MPT to expand treatment alternatives for these patients. In this case report, we represent a 13-year-old adolescent diagnosed with giant breast MPT with RMS differentiation and pulmonary metastasis. The initial step in the treatment process involved radical surgical resection, followed by the administration of four cycles of VDC/IC chemotherapy, which is widely recognized as the standard chemotherapy for RMS. Regrettably, the delay in initiating chemotherapy resulted in minimal observable changes in the size of the pulmonary metastatic nodule. Additionally, a comprehensive literature review on the characterization of MPT with heterogeneous differentiation was conducted to enhance comprehension of the diagnosis and treatment of this uncommon disease in clinical practice. Meanwhile, this case also reminds the doctors that when we diagnose a patient as MPT, it is crucial to consider its heterogenous nature and promptly initiate adjuvant treatment. By targeting the differentiation element of MPT, it becomes feasible to overcome the previously perceived limitation of surgical intervention as the sole treatment option.

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Phyllodes Tumor of the Breast With Malignant Melanoma Component

Cited by 3 publications

References 24 publications

Pathologie der Mamillenregion

Pathologie der Mamillenregion

Expression of EMT markers and mode of surgery are prognostic in phyllodes tumors of the breast

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

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