Phyllodes Tumor With Malignant Stromal Morphology of the Vulva

Abstract

We present a hitherto unreported case of vulvar phyllodes tumor which displayed morphologically malignant stroma including rhabdomyosarcomatous cellular elements. Clinically, the 61-year-old patient is free of recurrence 1 year after wide local excision.

Phyllodes Tumor of Vulva: A Brief Diagnostic Review

“…22, 23 One case of phyllodes tumor of the vulva showed increased cellularity, stromal overgrowth, and increased mitotic activity, 15 whereas stromal condensation was reported in a recurrent lesion. 13 Immunohistochemical stains may be useful in this differential because the sarcomatous component of Müllerian adenosarcoma shows reactivity for WT1, CD10, and estrogen and progesterone receptors, 22 whereas stroma of the phyllodes tumor in the vulva was nonreactive for the above markers.…”

“…20 Stromal overgrowth, defined as no epithelial component in a 340 microscopic field, increased stromal cellularity with significant cytologic atypia, mitotic counts greater than 10 per 10 high-power fields, heterologous differentiation, and infiltrative growth pattern are features possibly suggestive of malignancy. 15 …”

“…[12][13][14] However, none of the reports of this entity, to our knowledge, has yet shown evidence of metastatic potential associated with its breast counterpart, despite a case report showing phyllodes tumor of the vulva with histologic features suggestive of malignancy. 15 In this report, we review the literature on clinical and pathologic findings of this rare entity. We also discuss the concepts regarding its etiology, differential diagnosis, and clinical implications.…”

Phyllodes tumour of the labia minora

“…Herein, we present a case of a benign appearing labial cyst which was pathologically determined to be consistent with a rare phyllodes tumour. Seventeen previously reported cases of vulvar phyllodes tumours have been reported in the literature2–12; however, our case represents the first reported tumour located in the labia minora. As these tumours are rarely found in the vulva, treatment and prognosis is less established13; we discuss the differential diagnosis, treatment and surveillance to be considered for these rare tumours.…”

“…There is no current classification or grading system for vulvar phyllodes tumours 3. Of the 17 reported cases, only 5 (29%) have been reported to be malignant,4 12 1 reported as borderline5 and the remainder reported as benign or not reported. Only three (18%) recurrences of phyllodes tumours have been reported 6 10 12.…”