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PubMed1980

[The role of mammography in the diagnosis of cystosarcoma phylloides (author's transl)].

Cystosarcoma phylloides is not a single disease entity, but, a spectrum, which includes a benign, a non-metastatic malignant and a metastatic malignant form. Neither macroscopic nor microscopic examinations enable one to prediction as to whether the tumor is of a potentially metastatic kind or not. Neither pain nor infiltration or ulceration of the skin are reliable signs of malignancy; palpable axillary lymphnodes are misleading too. The treatment is composed of either a wide local excision of the tumor or a simple mastectomy. In cases where the lymphnodes have increased in size, simple mastectomy plus axillary lymphnodes dissection will be done. Since most tumor recurrence occurs following a local excision of the tumor only simple mastectomy is the surgical method of choid. The author presented two cases, examined by mammography; one case of malignant cystosarcoma phylloides malignum and one case of carcinoma. Both were similar in their clinical and radiographic presentation. Both cases demonstrate the difficulty of radiographie and pathologic diagnosis. A warning is given to radiologists not to compete with the pathologists for the histologic diagnosis but to limit themselves to suggest the presence of a possibly malignant tumor and the need for surgery.

Adult↗

PubMed2004

[Primary breast sarcoma. A retrospective study of 42 patients treated at the Bergonié Institute during a 32-year period].

OBJECTIVE: To evaluate the experience of a single cancer center with unusual tumors. To analyze Primary breast sarcomas (PBS). To investigate treatment and prognostic factors influencing overall survival (OS) and disease-free survival (DFS). PATIENTS AND METHODS: Retrospective study of a series of 42 patients. We reviewed the clinical records and pathology slides of 42 women with PBS treated in our institution between 1970 and 2002. Log-rank tests were used to determine OS and DFS. RESULTS: The median age at diagnosis was 56.9 years (24-81 years). Surgery was part of the therapeutic strategy in all the patients. Patients with angiosarcoma and those with malignant cystosarcoma constituted distinct populations. The 10-year OS and DFS rates were 53% and 55% for angiosarcoma patients and 89% and 100% for cystosarcoma patients (p=0.009 and 0.01 respectively). CONCLUSION: Careful preoperative multidisciplinary assessment is required before making the decision to treat. Mastectomy is generally indicated. Axillary lymph node dissection is not indicated.

Adult↗

PubMed1983

Fatal metastatic cystosarcoma phylloides in a young woman. Report of a case.

A fatal metastatic cystosarcoma phylloides occurred in an 18-year-old woman. The rapid increase in the tumor size and the histologic pattern shifting to an entirely sarcomatous growth contrasted with the maintenance of good general condition for several months. The hazards of conservative surgery in developing countries are discussed in the framework of this rare case in this age group.

Adolescent↗

PubMed1981

Cystosarcoma phylloides: a case presentation.

A case of cystosarcoma phylloides is presented here showing the natural history of this disease both clinically and pathologically from 1962 through 1979, and demonstrating the management of this disease by surgery and by chemotherapy with the use of adriamycin at 25 mg/m2 daily, times three days, every 28 days, which to out knowledge has not been used in this particular setting.

Breast Neoplasms↗

PubMed1983

Recurrent cystosarcoma phylloides of breast: extensive full-thickness excision of chest wall with immediate repair using steel mesh and a latissimus dorsi myocutaneous flap.

The case of a young woman with a massive recurrent cystosarcoma phylloides of the breast is presented in whom a full thickness excision of the chest wall was carried out en bloc together with four ribs. The large full-thickness defect of the chest wall was reconstructed with stainless steel mesh and covered by a latissimus dorsi myocutaneous flap. The management of post-operative paradoxical movement is also described.

Adolescent↗

PubMed1975

Metastatic cystosarcoma phylloides in an adolescent girl: an unusually malignant tumor.

The first case of metastatic cystosarcoma phylloides in an adolescent is reported. This case also represents the first reported response of this tumor to chemotherapy and irradiation. This tumor showed an unusually rapid rate of cell division probably making it more susceptible to these agents. The importance of an early diagnosis and definitive excision is stressed.

Adolescent↗

PubMed1996

Cystosarcoma phylloides: heterogeneity in a rare tumour type.

Mammary cystosarcoma phylloides is a rare tumour, and clear guidelines for its clinical management are lacking. We present three cases from the Western Infirmary which illustrate the range of behaviour that these tumours can manifest, and discuss some of the clinical problems that they present.

Adult↗

PubMedDate not supplied

A case of intracystic breast cancer.

The case of a 70-year-old female patient with family history of breast cancer come to the breast Unit for the presence of a nodular swelling in the right breast is discussed. On mammography and US a gross cystic neoformation with vascularized mural nodes was identified. Another contralateral solid nodular neoformation suggestive of malignancy was also present. Diagnostic completion with MRI confirmed the mixed solid, partly cystic nature of the right lesion, leading to the differential diagnosis with cystosarcoma phylloides and intracystic tumor. On the left side, MRI confirmed the presence of the second lesion whose morphologic and dynamic characteristics suggested a neoplastic lesion. At the anatomopathological examination the left lesion was shown to be an infiltrating ductal carcinoma; the right lesion was shown to be an intracystic tumor.

Aged↗

PubMed1979

Cystosarcoma phylloides. A steroid receptor and ultrastructure analysis.

Six cases of cystosarcoma phylloides were evaluated by ultrastructure and steroid receptor analysis. Electron microscopy of the lesions supported previous reports of a heterogeneous tumor consisting of pleomorphic mesenchyme and normal or proliferative epithelium. In each case estrogen and progesterone receptor analysis indicated the presence of a nonsaturable estrogen and progesterone 4S binding protein rather than a specific steroid receptor as suggested by previous studies.

Adolescent↗

PubMed1987

Giant breast tumours of adolescence.

The giant breast tumour of adolescence is rare in Caucasians. Six cases seen over 10 years are reported to illustrate diagnostic problems and highlight the importance of conservative management. Malignancy may be suspected because of rapid growth and skin ulceration. Conversely, the lesion may be considered to be no more than asymmetrical breast development or virginal hypertrophy. Clinical management problems have arisen because of confusion between fibroadenoma and the term cystosarcoma phylloides, previously used for tumours seen in older patients. The histological distinction between giant fibroadenoma and phylloides tumour has important clinical implications in older age groups. These implications do not apply to Caucasian adolescents in whom these tumours have a wide spectrum of histological appearances but uniformly benign clinical behaviour. Giant fibroadenoma of adolescence is a satisfactory designation and simple enucleation a satisfactory treatment, irrespective of the histological appearance.

Adenofibroma↗

PubMedDate not supplied

Surgical breast lesions in adolescent patients and a review of the literature.

BACKGROUND/PURPOSE: Breast disease in adolescence is uncommon, with most presenting lesions being benign. Breast lesions in adolescent patients are discussed in this article with a review of world literature. PATIENTS AND METHODS: The clinical records of 30 patients operated upon for breast lesions in our hospital during 18 years were reviewed. RESULTS: There were 25 female and five male patients, ranging in age from 16 years. Twenty-five female patients were operated on for breast mass and/or discharge, and five male adolescents were operated on for gynaecomastia. The most frequent (n = 27) complaint was palpation of mass in the breast. The most common histologies were fibro-adenoma (n = 14) and gynaecomastia (n = 5). The average duration of pre-operative symptoms was 2.9 months for fibro-adenoma, 1.6 years for gynaecomastia (extremes 2 days to 1 year). Nipple discharge was observed in three patients. Average diameters of palpable masses were 2.9 cm for fibro-adenomas and 5 cm for gynaecomastia. Lesions were excised surgically in all patients. Masses diagnosed as fibro-adenomas in the pre-operative period were reported upon pathological examination to be precancerous lesions such as cystosarcoma phylloiedes, juvenile fibro-adenoma, solitary intraductal papilloma, tubular adenoma and juvenile papilloma. One postoperative wound infection and one recurrence of fibro-adenoma was seen. CONCLUSION: The most frequently encountered breast masses were fibro-adenomas. These lesions are mostly benign in nature and can be treated conservatively but the possibility of precancerous lesion should be considered during follow-up.

Adolescent↗

PubMed1992

[MR tomography of cystosarcoma phylloides. A case report].

This is the first time a report is being published in medical literature on the MR imaging of a cystosarcoma phylloides tumour after intravenous contrast agent administration. MR tomography enabled complete visualisation of the tumour even in the region close to the thoracic wall, as well as clear delineation against the non-tumorous glandular tissue. This means that the limits along which complete extirpation of the tumour could be performed, were determined accurately before the operation, such complete removal being imperative to avoid tumour recurrence.

Breast Neoplasms↗

PubMed1979

Steroid receptors in sarcomatous lesions.

Clinical observations showed that the natural history of sarcomatous lesions may be different among males and females, and it may be influenced by hormonal factors. Estrogen receptors (ER) were measured on biopsy specimens of melanoma (two patients), soft-tissue sarcoma (four patients), cystosarcoma phylloides (five patients), benign breast tissues (27 patients), and breast carcinoma (109 patients). Thirty-four specimens also had progesterone receptors (PR) analyzed. One of the five cystosarcoma phylloides and five of the six nonmammary sarcoma tissues contained ER (mainly of the 4 Svedburg (S) variety) of more than 7 femtomoles (fmoles)/mg cytosol proteins (6/11 = 54%). For comparison three of the 14 fibroadenoma specimens and two of the 13 patients with other benign lesions had positive ERs (5/27 = 19%), whereas 56% of the breast carcinomas were ER positive. Since the amount of 8S ER found in sarcomatous tissues is relatively low, hormonal treatment would not be effective.

Adenocarcinoma↗

PubMed1951

Giant intracanalicular fibroadenoma. With report of five cases.

Five cases of giant intracanalicular fibroadenoma ("cystosarcoma phylloides") were observed at one hospital in a period of three years. In a search of the literature, additional reports of breast tumors of this kind, not included in previous reviews, were noted. As there is record of 229 cases, it would appear that this rapidly growing benign tumor should be kept in mind in the diagnosis of masses in the breast. If removal is incomplete, there may be recurrence. Simple mastectomy is the treatment of choice. Radical mastectomy should be avoided.

Adult↗

PubMed1995

[Cystosarcoma phylloides of the breast--2 case reports].

Two cases of Cystosarcomata phylloides (C. ph.) in the breast were reported. In the first one after excision of the palpaple tumour mass the histological examination revealed a fibroadenoma with signs of C. ph. in the excision margins. The reported high rate of local recurrence also in cases of benign tumour type and/or in situ remained tumour structures (stromal hyperplasia) gave the reason for a second operation procedure, an enlarged quadrantectomy. In the second case sarcomatic degenerated areas and a high rate of atypical mitotic figures were found (> 20 mitosis/10 HPF). Therefore an ablative surgery was recommended.

Adult↗

PubMed2005

Breast cancer and borderline ovarian carcinoma in young patients--case report.

Cystosarcoma phyloides is a breast cancer with deterrent features because of its size and fast growth. Borderline ovarian tumors comprise 10% to 15% of all epithelial tumors of the ovary. Regardless of the tumor type (serous, mucinous, clear cell, Brenner, mixed) they can be benign, borderline or malignant. There is a close physiological relation between the breasts and genital tract. By routine examination of girls in secondary schools, suspected ultrasonography findings were found in two out of 180 examinees.

Adolescent↗

PubMed1984

[Malignant metastasizing cystosarcoma phylloides of the breast. Ulm collection of rare tumors: VI].

Malignant cystosarcoma phylloides represents the malignant form of mammary fibroadenoma. In spite of atypical epithelial components, the biological behaviour of the tumour depends on malignant transformation of the dominant mesenchymal stromal tissue in the tumour. The histological appearance, often extremely variable, usually corresponds to a fibrosarcoma. Lipoblastic, chondroid and myxoid structures or areas of ossification may be present, although a completely dedifferentiated cystosarcoma is rare. The epithelial structures which are typically canalicular may reveal hyperplastic and dysplastic changes as well as an apocrine change and occasionally squamous metaplasia. Besides aggressive local infiltration, hematogenous metastasis of the skeletal system and lungs is common. Therapy is dependent on the extent of local tumour growth as well as on the degree of metastasis and usually takes the form of radical mastectomy with lymphadenectomy and postoperative radiotherapy. Local recurrence is found in over 50% of the cases and the 5-year survival rate is in the order of 70%.

Breast Neoplasms↗

PubMed1987

Cystosarcoma phylloides in the adolescent female.

Between 1979 and 1985, five adolescent females have undergone excision of cystosarcoma phylloides. Mean age at presentation was 15 years with a range of 13 to 18 years. Clinical characteristics unique to this diagnosis included a recent history of rapid growth and the large size of the breast mass (mean diameter 7 cm) at initial presentation. Each patient underwent "cosmetic" excisional biopsy utilizing either a circumareolar or inframammary approach. In four patients, the neoplasm was benign with no postoperative recurrence (mean follow-up 33.8 months). The remaining lesion was malignant (liposarcoma) and subsequent simple mastectomy was performed. There was no evidence of disease at 35 months.

Adolescent↗