Recurrent Phyllodes Tumor of the Vulva: A Case Report With Review of Diagnostic Criteria and Differential Diagnosis

Abstract

Phyllodes tumor of the vulva is extremely rare with only 6 cases reported in the literature. We report a case of recurrent phyllodes tumor of the vulva in a 39-year-old woman. The tumor showed biphasic morphology with a typical leaf-like pattern and a cellular stroma with rare mitosis. Expression of estrogen receptors, progesterone receptors mammoglobin, and BRST-2 was shown in the epithelial component. Review of literature with emphasis on diagnostic features and differential diagnosis are discussed.

Phyllodes Tumor of Vulva: A Brief Diagnostic Review

“…The prognosis of this neoplasm is uncertain, with local recurrence being the most common complication. [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.…”

“…Recurrence was described in a lesion classified as benign, most likely related to prior incomplete resection, 12 but additional excision with clear margins was curative. Therefore, close follow-up is warranted, irrespective of histologic categorization.…”

Phyllodes Tumor With Malignant Stromal Morphology of the Vulva

“…The ''ectopic'' tissue is, in fact, a part of the normal, microscopic anatomy of the lower anogenital tract; hence, is best named anogenital mammary-like glands (MLGs). MLGs, similar to the breast tissue, are immunopositive for BRST-2, mammaglobulin, and estrogen/progesterone receptors (1,8), but are different from true ectopic mammary tissue based on the following features: (1) they have simpler glandular configuration, (2) a greater number of glands, (3) ultrastructurally, the secretory epithelial cells have electron-lucent secretory granules not seen in mammary glands, and (4) in contrast to traditional teaching, the milk line in humans does not extend to the lower anogenital area (5,9). In agreement with the above concept, extensive search for ectopic breast tissue in our case was fruitless; rather, we encountered glands adjacent to the tumor and some located within the tumor that resembled MLGs.…”

“…Vulvar phyllodes tumor is exceptionally rare with less than 10 detailed cases reported in the literature (1)(2)(3)(4)(5)(6)(7)(8). None of these displayed morphologically malignant stromal features.…”

Phyllodes tumor of the vulva: report of two cases

“…It is also known to occur in various other anatomical sites, including the vulva, prostate and axilla (1)(2)(3)(4)(5)(6)(7)(8)(9). The tumor has epithelial and stromal components.…”