Malignant Phyllodes Tumor of the Breast with Liposarcomatous Differentiation, A Rare Case

SEDA TAS AYÇİÇEK , Hasan Yaldız

  • SEDA TAS AYÇİÇEK: Aksaray Eğitim ve Araştırma Hastanesi
  • Hasan Yaldız: Aksaray Eğitim ve Araştırma Hastanesi
  • Year : 2024
  • Vol : 40
  • Issue : 4
  •  Page : 202-204
ABSTRACT
Phyllodes tumors are rare fibroepithelial neoplasms and comprise less than 1% of all breast tumors. Heterologous sarcomatous differentiation is rarely observed in phyllodes tumors and in this study, a case of phyllodes tumor containing heterologous liposarcoma component is presented. A rapidly expanding mass in the left breast of an 86-year-old woman led to her admission to the general surgery outpatient clinic. A BI-RADS 4 nodular lesion was detected in the mammographic examination and was evaluated as suspicious for phyllodes tumor. Left modified radical mastectomy material was sent to our laboratory. Macroscopic examination revealed a nodular mass measuring 9.5x9x8 cm with focal infiltrative borders in breast tissue sections. In histological sections, the tumoral lesion was noted to have hypercellular, pleomorphic stroma and in some places the typical leaf-like architecture of phyllodes tumor. A well-differentiated liposarcoma component was observed in the tumor, containing lipoblast-like cells with single and multiple vacuoles, clear cytoplasm, and hyperchromatic nuclei. In the light of all the findings, the case was reported as malignant phyllodes tumor containing heterologous liposarcoma component. Phyllodes tumors showing heterologous sarcomatous differentiation are quite rare and when sarcomatous neoplasia is seen in the breast, phyllodes tumor ought to be taken into account while making a differential diagnosis. In order to distinguish phyllodes tumor with sarcomatous differentiation from primary breast sarcomas, it is very important to show the benign epithelial component of the tumor by taking multiple samples.
Keywords: Phyllodes tumor, breast, liposarcoma
Cite this Article As : Aycicek Tas S, Yaldız H. Malignant Phyllodes Tumor of the Breast with Liposarcomatous Differentiation, A Rare Case. Selcuk Med J 2024;40(4): 202-204

Download Citation: Endnote/Zotero/Mendeley (RIS) RIS File

Download Citation: BibTeX BibTeX File

Conflict of interest : The authors declare that they have no conflict of interest.
This article is published under the CC BY-NC 4.0 license.
Selcuk Medical Journal
2024, Vol. 40 (4)
ISSN: 1017-6616
E-ISSN: 2149-8059
Received : , Accepted : , Published Online :

References

  1. 1. Bogach J, Sriskandarajah A, Wright FC, Look Hong N, Panel CPTC. Phyllodes tumors of the breast: Canadian national consensus document using modified delphi methodology. Ann Surg Oncol. 2023;30(11):6386–97. DOI: 10.1245/s10434-023-13912-7
  2. 2. Chen K, Xu J, Wang W, Jiang R, Zhang H, Wang X, et al. Clinical outcomes and biomarkers of phyllodes tumors of the breast: A single‐center retrospective study. Cancer Med. 2023;12(10):11363–74. DOI: 10.1002/cam4.5849
  3. 3. Yoshida M, Shioya A, Morioka E, Inokuchi M, Yamada S. Giant Borderline Phyllodes Tumor Fungating Through the Skin as Fleshy Polypoid Outgrowths. Cureus. 2024;16(5). DOI: 10.7759/cureus.61020
  4. 4. Li W, Ou Q, Li Y, Yuan LY. Malignant phyllodes tumor of the breast with predominant osteosarcoma and chondrosarcomatous differentiation: a rare case report and review of literature. Front Oncol. 2024;14. DOI: 10.3389/fonc.2024.1372710
  5. 5. Lissidini G, Mulè A, Santoro A, Papa G, Nicosia L, Cassano E, et al. Malignant phyllodes tumor of the breast: a systematic review. Pathologica. 2022;114(2):111. DOI: 10.32074/1591-951X-754
  6. 6. Pollard SG, Marks P V, Temple LN, Thompson HH. Breast sarcoma. A clinicopathologic review of 25 cases. Cancer. 1990;66(5):941–4. DOI: 10.1002/1097-0142(19900901)66:53.0.co;2-b
  7. 7. Narla SL, Stephen P, Kurian A, Annapurneswari S. 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. Indian J Pathol Microbiol. 2018;61(4):577–9. DOI: 10.4103/IJPM.IJPM_238_17
  8. 8. Fiks A. Cystosarcoma phyllodes of the mammary gland—müller’s tumor: For the 180th birthday of Johannes Müller. Virchows Archiv A. 1981;392:1–6. DOI: 10.1007/BF00430543
  9. 9. Carpenter M, Masood S, Sharma S, Makary R, Hatch P, Marji N. Malignant Phyllodes Tumor With Chondroblastic Osteosarcomatous Differentiation: A Case Report. Cureus. 2024;16(7). DOI: 10.7759/cureus.63915
  10. 10. Hamdy O, Saleh GA, Raafat S, Shebl AM, Denewer A. Male breast huge malignant phyllodes. Chirurgia (Bucur). 2019;114(4):512–7. DOI: 10.21614/chirurgia.114.4.514
  11. 11. Rodrigues MF, Truong PT, McKevitt EC, Weir LM, Knowling MA, Wai ES. Phyllodes tumors of the breast: the British Columbia Cancer Agency experience. Cancer/Radiothérapie. 2018;22(2):112–9. DOI: 10.1016/j.canrad.2017.08.112
  12. 12. Lee BJ, Pack GT. Giant intracanalicular fibro-adenomyxoma of the breast. The so-called cystosarcoma phyllodes mammae of Johannes Müller. Am J Cancer. 1931;15(4):2583–609. DOI: 10.1097/00000658-193101000-00034
  13. 13. Rakha E, Sasano H, Wu Y. WHO classifcation of tumours editorial board: Breast tumours. WHO classifcation of tumours series,. 2019; DOI: 10.1111/his.14091
  14. 14. Isotalo PA, George RL, Walker R, SenGupta SK. Malignant phyllodes tumor with liposarcomatous differentiation. Arch Pathol Lab Med. 2005;129(3):421–2. DOI: 10.5858/2005-129-421-MPTWLD
  15. 15. Boutrus RR, Khair S, Abdelazim Y, Nasr S, Ibraheem MH, Farahat A, et al. Phyllodes tumors of the breast: Adjuvant radiation therapy revisited. The Breast. 2021;58:1–5. DOI: 10.1016/j.breast.2021.03.013