Well-differentiated liposarcoma of the breast arising in a background of malignant phyllodes tumor in a pregnant woman: A rare case report and review of literature

Narla, Swetha Lakshmi; Stephen, Punitha; Kurian, Achamma; Annapurneswari, S

doi:10.4103/ijpm.ijpm_238_17

Cited by 11 publications

(11 citation statements)

References 8 publications

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“…Figure 1 shows the number of articles retrieved in various stages of the search. Date of publication of the earliest and latest relevant articles were 1954 12,13 and 2018, 14,15 respectively. Three articles were in languages other than English and French, consisting of Spanish, 16 Polish, 17 and Portuguese.…”

Section: Search Resultsmentioning

confidence: 99%

Phyllodes Tumor of the Breast during Pregnancy and Lactation; A Systematic Review

et al. 2020

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Background: Phyllodes tumor (PT) is a rare tumor of the breast, which may occur during pregnancy or lactation. Several studies have reviewed and discussed PT occurring in pregnancy, gathering up to 14 patients. We performed a thorough systematic review of the literature in an attempt to find all reported cases, and identify their common characteristics. Methods: We searched Google scholar, PubMed, Ovid Medline, Scopus and ClinicalTrials.gov with several relevant combinations of keywords, looking for texts or abstracts without any date or language limitations, but using only English keywords. The existing literature only consisted of case reports and series; therefore any paper including one or several cases of PT presenting during pregnancy or breastfeeding was recognized as eligible. Articles with vague description of the tumor which made the diagnosis uncertain, and those lacking data about the tumor and management data were excluded. We contacted authors for more details in cases with incomplete information. Results: After excluding those with very deficient data, we included 37 studies, counting 43 cases. The mean age of the patients was 31 years (21-43 years). Some features were different from usual PT: bilaterality (16.2%), large size (14.2 ± 8.6 cm), rapid enlargement (79.5%), and rate of malignancy (60.5%). Conclusion: Our findings show high rates of bilaterality, large size, rapid growth, and malignant pathology in the reported gestational PTs.

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Section: Search Resultsmentioning

confidence: 99%

Phyllodes Tumor of the Breast during Pregnancy and Lactation; A Systematic Review

et al. 2020

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“…Our patient had not received radiotherapy in the past nor had any benign lesion prior. They occur generally as pure primary liposarcoma or in cystosarcoma phyllodes 7 . Mostly, the age of appearance is between 45 and 55 years.…”

Section: Discussionmentioning

confidence: 99%

“…They occur generally as pure primary liposarcoma or in cystosarcoma phyllodes. 7 Mostly, the age of appearance is between 45 and 55 years. They are mostly unilateral, infiltrative, and either well-circumscribed or multinodular.…”

Section: Discussionmentioning

confidence: 99%

Primary dedifferentiated liposarcoma of the breast: A case report

Shrestha

Kharel

Shrestha

et al. 2022

Clinical Case Reports

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“…Although mastectomy is likely to be recommended for some locally advanced tumors, breast-conserving surgery remains a good option for cases were surgical clear margins can be achieved. The vast majority of cases described conservative surgery as a first approach, but for most of the malignant cases, mastectomy was recommended in order to achieve clear margins as completion surgery [22][23][24][25]. Fatal outcome is uncommon for these diagnoses, since most of the tumors have a rapid growth pattern during pregnancy, and usually patients will approach a doctor sooner for diagnosis.…”

Section: Discussionmentioning

confidence: 99%

Malignant Phyllodes Tumor of the Breast and Pregnancy: A Rare Case Report and Literature Review

et al. 2021

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Phyllodes Tumor (PT) is a rare fibroepithelial breast tumor that can behave differently depending on its biologic features. Traditionally, PTs are classified by their histologic features into benign, borderline, and malignant. In most cases that were reported, all PTs may recur, but only the borderline and malignant PT can metastasize. PT usually occurs as a breast lump or accidental finding on ultrasound (US) examination. The clinical features include a well-defined breast mass, regular or lobulated. The diagnosis is based on the integration of morphology features, but remains challenging, particularly in the distinction from fibroadenomas. We report a case of a 36-year-old patient who presented for a voluminous breast mass, rapidly growing in the past 3–4 months. At presentation, the patient was 19 weeks pregnant. The breast tumor had the clinical and US aspect of PT. A core needle biopsy was obtained, confirming a benign PT, and local excision was performed with no postoperative complications. The final pathology report showed a borderline PT with close resection margins of 1 mm. Immunohistochemistry (IHC) established the diagnosis of malignant PT with heterologous sarcomatous differentiation. The case was discussed in the multidisciplinary tumor board (MDT) and mastectomy was recommended. The patient fully consented but refused surgery at 25 weeks’ gestation, fearing premature delivery. The right breast was closely monitored by US, and at 9 weeks after the first surgery, signs of local recurrence were detected. At 35 weeks’ gestation, right mastectomy was performed, with no perioperative complications. The pregnancy was closely followed up and no complication were found. The final pathology report describes multiples PT recurrences with heterologous sarcomatous differentiation. The pregnancy outcome was uneventful, and the patient delivered a healthy child vaginally at term with no peripartum complication. Postpartum, a computer tomography (CT) examination of the head, thorax, abdomen and pelvis was performed, with no evidence of metastases. Adjuvant chemotherapy and radiotherapy completed the treatment. The follow-up and CT scan showed no metastases or further recurrence 4 years after diagnosis. In conclusion, diagnosis of PT can be difficult, especially because of the easy confusion with fibroadenoma of the breast. There are rare cases when a pathology exam needs further assessment and IHC is recommended for accurate diagnosis. Although malignant PT is rare and accounts for <1% of all breast cancers, the diagnosis and treatment that are recommended are based on the reported cases. Moreover, when complete surgical excision is achieved, the rates of recurrence and distant metastases are low, and adjuvant therapy might not be necessary.

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Well-differentiated liposarcoma of the breast arising in a background of malignant phyllodes tumor in a pregnant woman: A rare case report and review of literature

Cited by 11 publications

References 8 publications

Phyllodes Tumor of the Breast during Pregnancy and Lactation; A Systematic Review

Phyllodes Tumor of the Breast during Pregnancy and Lactation; A Systematic Review

Primary dedifferentiated liposarcoma of the breast: A case report

Malignant Phyllodes Tumor of the Breast and Pregnancy: A Rare Case Report and Literature Review

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