hyllodes tumor of the breast: a case report

Introduction: Phyllodes tumors are thought to derive from the perilobularperiductalspecial stroma. Among the spectrum of fibroepithelial breast tumors,phyllodes tumors are to be placed at the far end of stromal progression. Theoccurrence of these tumors are rare with incidence of 2.1 per 1 million women.Large tumors may extend into the skin or invade to the chest wall. The maindifferential diagnosis is that with fibroadenoma of intracanalicular type andadenomyoepithelial tumors. We present here a rare case of Phyllodes tumor ofthe breast.Case presentation: We present a case of Phyllodes tumor in right breast tissuediagnosed in a 43 year old woman at the Rajaee Hospital, in December 2011.The patient presented with a palpable mass in right breast for five months. Onphysical examination, there was a mobile, well circumscribed mass with 5.5 cmin diameter in the right upper outer quadrant. The overlying skin wasunremarkable. Associated axillary lymph node was not enlarged.Ultrasonography (US) study revealed a well - circumscribed, lobulated masswith heterogenous internal echoes. Mammography display, a well defined masswithout any microcalcification. The patient underwent a wide excision.Histopathological review of the excised lesion revealed a well-circumscribedtumor composed of mesenchymal and epithelial structures. The epithelialelement composed of elongated leaf-like epithelial proliferation. Themesenchymal element displayed stromal hypercellularity especially aroundductal areas. The cellular pleomorphism , coagulative necrosis, or high mitoticactivity was not found. These microscopic findings most probably were in favorof benign phyllodes tumor. After six months follow up, evidence of diseaserecurrence was not noted.Conclusion: Phyllodes tumor grading is based mainly on stromalhypercellularity, stromal component overgrowth, stromal cells pleomorphism,increased mitotic activity, and the microscopic quality of the peripheral tumorborder. Most be remembered, one of common findings of phyllodes tumors wasintra-tumoral heterogeneity, therefore, tumor grading should be assessed onexcisional biopsies for extensive sampling and to avoid undergrading error.

Keywords:

Phyllodes tumor , Breast tissue