[1], This variety comprises 60% to 75% of all phyllodes tumors. *Correspondence: Lingyan Kong, klyan@163.com; Zhengyu Jin, cjr.jinzhengyu@vip.163.com, Creative Commons Attribution License (CC BY). 2003, 27: 343-348. Considering the size and the rapid growth of the mass, surgical excision was recommended without biopsy. Study concepts and design: LK, FZ,ND, YJ, HL, MW, MY, FZ, SZ. The tumor measures ____ in maximal dimension and is clear from (specify if < 1 cm ____) / involves the resection margins. [23] Large tumors require a mastectomy. Tl: +84 913 025 122 (Whatsapp)
Based on histologic features, including nuclear atypia, stromal cellularity, mitotic activity, tumor margin appearance, and stromal overgrowth, the World Health Organization (WHO) classifies Phyllodes tumors benign, borderline, and malignant. Therefore, close follow-up is needed. 2008, 51: 252-254. FFDM and DBT showed multiple irregular high-density masses with lobulated margin, partially integrated. Most phyllodes tumors behave benignly, with local recurrences occurring in a small proportion of cases. PubMed 
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Chaque itinraire met en valeur des traits particuliers du pays visit : le Cambodge et le clbre site dAngkor, mais pas que ! WebPeriductal stromal condensation may be seen Frankly sarcomatous stroma may be seen in malignant phyllodes tumor Heterologous differentiation may occur in malignant phyllodes tumor Liposarcoma Osteosarcoma Chondrosarcoma Rhabdomyosarcoma Grading determined by presence or absence of atypical stromal features Kristin C Jensen MD 12. Identify the etiology of phyllodes breast tumors. In our case, the tumor had no obvious phyllode fissure; however, it partially retained the structure of breast lobules. As far as we know, only sporadic cases were reported ( 1 9 ). This activity describes the evaluation and treatment of phyllodes tumors and highlights the interprofessional team's role in managing patients with this condition. As a biphasic tumor, PDST shows both benign ductal epithelium and non-phyllodes sarcomatous stroma. Upon clinical examination, we found, in the upper outer quadrant of the right breast, a small mass measuring approximately 2cm in size, round in shape, with no signs of inflammation and not associated with axillary lymph nodes. They were mainly distinguished by pathological characteristics. Feel free to get in touch with us and send a message. Periductal stromal sarcoma is an extremely rare malignant fibroepithelial tumor of the breast which is characterized by its biphasic histology with benign ductal elements and a sarcomatous stroma made of spindle cells and lacking phyllodes architecture. Researchers have postulated that stromal induction of phyllodes tumors can occur due to growth factors produced by the breast epithelium. It is characterized by proliferation of atypical spindle cells surrounding benign mammary Breast Imaging-Reporting and Data System (BI-RADS) 3. Written informed consent was obtained from the individual for the publication of any potentially identifiable images or data included in this article. [28] Rarely, metastases can involve the liver and heart. doi:10.1177/1066896920929086. 2000, 94: 84-91. Nous allons vous faire changer davis ! However, because of the rarity of the disease, its radiological features were seldom reported. The prognosis of patients with PSS is unclear; thus, more cases of this unusual morphologic variant and longer follow-up of existing and future patients are needed to determine the optimal management and the clinical behavior of this neoplasm. As for the determination of malignancy, this case demonstrated invasive growth, significant pleomorphism, active mitosis (>10/10 HPF or >5/mm2) with pathological mitosis, and was rich in mesenchymal cells, so it was classified as malignant (Figure6). AuSud, vous apprcierez la ville intrpide et frntique de Ho Chi Minh Ville (formellement Saigon) ainsi que les vergers naturels du Delta du Mekong notamment la province de Tra Vinh, un beau site hors du tourisme de masse. [20], On ultrasound, phyllodes tumor present as a hypoechoic, partially indistinct, or partially circumscribed mass with frequent posterior enhancement. The spindle-cell stromal nuclei are uniform, and mitoses are rare, generally less than 5 per 10 high-power fields. [7], Unlike breast carcinoma, phyllodes tumors start outside of the lobules, and ducts, in the breasts connective tissue, called the stroma, including the ligaments and fatty tissue surrounding the lobules, ducts, lymph, and blood vessels in the breast. Epithelial structure surrounded by a stroma with moderate atypical cells showing mitosis. https://creativecommons.org/licenses/by/2.0 Google Scholar. WebPeriductal Stromal Tumor of the Breast: One Institution's Review of 6 Tumors Over a 22 Year Period With Immunohistochemical Analysis Int J Surg Pathol. J Surg Res. It is most likely to originate from the periductal stroma (10). Other names for these tumors include phylloides tumor and cystosarcoma phyllodes. Puisez votre inspiration dans nos propositions d'excursionet petit petit, dessinez lavtre. sharing sensitive information, make sure youre on a federal Chen WH, Cheng SP, Tzen CY, Yang TL, Jeng KS, Liu CL, Liu TP. 
Edited by: Tavassoli FA, Devilee P. 2003, Lyon: IARC Press, 101-102. Stromal overgrowth is often absent. H/E 4x. 2023 BioMed Central Ltd unless otherwise stated. Pathol Int. 69372 Lyon CEDEX 08, France: IARC Press, 150 Cours Albert Thomas (2019). The key imaging characteristics were the following: (1) multiple solid lobulated lesions comprising nearly the entire right breast; (2) hypoechoic and heterogeneous echo patterns with internal separations and abundant blood flow were noted; (3) FFDM and DBT showed multiple irregular high-density masses with lobulated margin, partially integrated. WebThe tumor microenvironment regulates tissue development and homeostasis, and its dysregulation contributes to neoplastic progression. When the size of a fibroadenoma is greater than 5cm with increased stromal cellularity and epithelial hyperplasia on tissue analysis, it is classified as juvenile fibroadenoma (11). 11:577227. doi: 10.3389/fonc.2021.577227. 2017YFC1309100) and the National Public Welfare Basic Scientific Research Program of Chinese Academy of Medical Sciences (2018PT32003 and 2017PT320004). WebCriteria for periductal stromal hyperplasia included 1) nodular, bland stroma growing as cuffs around normal or altered ducts, 2) no to minimal atypia, and 3) at most 02 stromal mitotic figures per 10 high power fields. In this case, infiltrative growth, rich in interstitial cells, obvious atypia, active mitosis (>10/10 HPF or 5/mm2), and pathological mitosis indicated malignancy. The histological features of PSS were defined by the Armed Forces Institute of Pathology (AFIP) [2] as follows: (1) a predominantly spindle-cell stromal proliferation of variable cellularity and atypia around open tubules and ducts devoid of a phyllodes pattern; (2) one or, more often, multiple nodules separated by adipose tissue; (3) stromal mitotic activity of 3/10 high-power fields; and (4) infiltration into surrounding mammary fibroadipose tissue. 
No use, distribution or reproduction is permitted which does not comply with these terms. The characteristics present on MRI are typically heterogeneously low signal on T1-weighted images, although areas of T1-hyperintense hemorrhage may be visible. Considering the infiltrative characteristic of the tumor, surgical excision with enough margin is required (6). These tumors are diagnosed when the mass does not possess all the adverse histological characteristics found in malignant phyllodes tumors. 
As a biphasic tumor, PDST shows both benign ductal epithelium and non-phyllodes sarcomatous stroma. Periductal stromal tumor (PDST) is a rare biphasic tumor of the breast that exhibits low-grade malignancy and intermediate behavior. Wabik A, Van Bockstal MR, Berlire M, Galant C. Int J Surg Pathol. It is most likely to originate from the periductal stroma ( 10 ). Most phyllodes tumors behave benignly, with local recurrences occurring in a small proportion of cases. Breast Imaging-Reporting and Data System (BI-RADS) 4A. Periductal stromal tumor (PST) of the breast is a rare fibroepithelial neoplasm with controversial pathogenesis. The residual breast ducts and lobules in the tumor maintained a normal contour, while the cell density at the epithelialmesenchymal junction did not increase significantly. The ducts in the tumor kept a nearly normal contour, and the stromal cellularity adjacent to the epithelium did not obviously increase. The Journal of pathology. The tumor infiltrated peripheral tissues, including fat (right middle margin). List the treatment and management options available for phyllodes tumors of the breast. Authors Longmei Zhao 1 , Miglena K Komforti 1 , Andrea Dawson 1 , J Jordi Rowe 1 Affiliation The lesion was histologically compatible with low-grade PSS. The mass had been steady at the size of a jujube until it grew rapidly during the few months before admission. 10.1006/jsre.2000.6001. She is currently doing well without any sign of recurrence for 25 months. The patient underwent extended mastectomy of the right breast. (6), PDST is more commonly seen in perimenopausal and postmenopausal women (6); however, a single case of PDST in a 14-year-old girl has also been reported (8). Chen CM, Chen CJ, Chang CL, Shyu JS, Hsieh HF, Harn HJ: CD34, CD117, and actin expression in phyllodes tumor of the breast. [22], Complete wide local excision with greater than 1 cm margins is often curative and reduces the risk of local recurrence. Department of Radiotherapy, National Institute of Oncology, Allal fassi Street, Rabat, 10100, Morocco, Ouafae Masbah,Issam Lalya,Iman Bekkouch,Khalid Hassouni,Tayeb Kebdani,Noureddine Benjaafar&Brahim Khalil Elgueddari, Department of Medical Oncology, National Institute of Oncology, Allal fassi Street, Rabat, 10100, Morocco, Laboratory of Pathology, National Institute of Oncology, Allal fassi Street, Rabat, 10100, Morocco, Laboratory of Pathology, Agdal Oukaimden Street, Rabat, 10100, Morocco, You can also search for this author in Periductal stromal sarcoma may evolve into a phyllodes tumor with time, as well as a specific soft-tissue sarcoma. Pathology (2011) 43:50910. It is characterized by proliferation of atypical spindle cells surrounding benign mammary ducts and infiltrating adjacent adipose tissue. Diagnostic problems due to the lack of phyllodes tumors cause diagnostic problems, because PSS is a distinct, low-grade breast sarcoma with no clinical or radiological specificity. The red box indicated the corresponding area shown in panel (B) Internal bar = 6mm. 1968, 22: 22-28. The authors declare that they have no competing interests. 
No adjuvant treatment was given. DBT was recommended than FFDM alone as the added value in recognizing suspicious features. The breast journal. Malignant phyllode tumors show a combination of marked nuclear pleomorphism of stromal cells, stromal overgrowth defined as the absence of epithelial elements in one low-power microscopic field containing only stroma, increased mitoses (greater than or equal to 10 per 10 HPF), increased stromal cellularity, which is usually diffuse, and infiltrative borders. The size may range from 1 to 45 cm and may occupy the entire breast. Margin status appears to be the most relevant factor for prognosis. Explorer le Vietnam dans toute sa grandeur ou juste se relaxer en dcompressant sur des plages paradisiaques. WebAbstract Periductal stromal hyperplasia is an exceedingly rare biphasic breast tumor with benign ductal elements and spindle-cell stromal proliferation lacking a phyllodes architecture. The primary care provider and nurse practitioner must refer patients with suspected breast masses to an oncologist for further workup. Pre-operative diagnosis is difficult because it reveals similar symptoms with other benign and malignant tumors with absence of specific Our patient is currently recurrence-free 50 months after treatment. FFDM (Senographe Essential, General Electric Company, USA) revealed integrated multiple irregular lobulated high-density masses comprising nearly the entire right breast that is asymmetrically enlarged compared to the left. [16][17], PAX3 and SIX1 expression by immunohistochemistry and gene expression analysis have recently been identified in borderline and malignant phyllodes tumors and correlate with a poor clinical outcome.[18]. Very rarely, the tumor may metastasize, most commonly in the cases of malignant grade tumors. Unlike phyllodes tumors, PDST does not present a leaflike architecture. Malignant phyllodes tumors carry a poor prognosis. Clinically, phyllodes tumors tend to present as unilateral firm, enlarging painless breast masses that stretch the overlying skin with striking distension of superficial veins. Manuscript preparation: ND, LK. The reported mass size was diversified between 0.2 and 20 cm (16, 1416). 2014 May; [PubMed PMID: 24438019], Gullett NP,Rizzo M,Johnstone PA, National surgical patterns of care for primary surgery and axillary staging of phyllodes tumors. The treatment results for 340 patients from a single cancer centre. Breast periductal stromal tumor (PDST) is a rare condition and accounts for less than 1% of all breast malignancies. In this study, we describe the case of a 48-year-old female who presented with a palpable mass in the right breast. 
Methods. 11. Trauma, pregnancy, increased estrogen activity, and lactation are occasionally implicated as factors stimulating tumor growth. Periductal stromal sarcoma is an extremely rare malignant fibroepithelial tumor of the breast which is characterized by its biphasic histology with benign ductal elements and a sarcomatous stroma made of spindle cells and lacking phyllodes architecture. The surgical pathology confirmed a PDST. These tumors are usually benign, but they can come back and cause the breast to look abnormal if not totally removed. Article (B) Higher power showed high stromal cellularity with obvious dysplasia, active mitoses, and pathologic mitosis [middle in the insert (embraced with red box, located left upper corner)]. WebPeriductal stromal tumor (PDST) is a rare biphasic tumor of the breast that exhibits low-grade malignancy and intermediate behavior. It is unclear whether this tumor belongs to the spectrum of [10] Preliminary data from array comparative genomic hybridization (CGH) demonstrate interstitial deletion 9p21 involving the CDKN2A locus and 9p deletion in malignant and some borderline phyllodes tumors. Part of 2009;59(8):588-591. The distinction betweenphyllodes tumor and fibroadenoma is important but can be difficult on core biopsy. Cite this article. Google Scholar. A retrospective search of our Pathology database from 2000 to 2021 identified 6 PST, all evaluated according to the Armed Forces Institute of Pathology (AFIP) criteria. A copy of the written consent is available for review by the Editor-in-Chief of this journal. However, IDC mass at this size is often associated with obvious malignancy features including infiltrative boundary and non-circumscribed margins that were not shown in this case. WebCriteria for periductal stromal hyperplasia included 1) nodular, bland stroma growing as cuffs around normal or altered ducts, 2) no to minimal atypia, and 3) at most 02 stromal mitotic figures per 10 high power fields. Periductal Stromal Tumor: A Rare Lesion With Low-Grade Sarcomatous Behavior. doi:10.1097/00000658-198504000-00020, 17. [19], The imaging findings on mammography are typically round lobulated dense mass with partially indistinct or circumscribed margins. Bloody nipple discharge caused by spontaneous infarction of the tumor has been described. PDST is distinguished info@meds.or.ke Microscopic (optional): Sections show a malignant spindle cell proliferation with diffusely increased cellularity, stromal overgrowth and marked stromal atypia. We welcome suggestions or questions about using the website. Blanchard DK, Reynolds CA, Grant CS, Donohue JH. PDST is distinguished from ph By using this website, you agree to our We report the clinical case of a 14-year-old Arabic boy with no history of disease who was presented to our hospital one year ago with a nodule of the right breast that was gradually increasing in size. US; breast; breast surgery; carcinoma; follow-up; mammography; periductal stromal tumor; phyllodes tumor. [21]MRI evaluation may be of benefit to evaluate for chest wall invasion in malignant phyllodes tumor. KH and TK were involved in drafting the manuscript and revising it critically for important intellectual content. 1969, 98: 384-387. 
After excision of the mass, she was followed up in the outpatient clinic for 25 months without local recurrence or distant metastasis. 2009 Jan-Feb; [PubMed PMID: 19141133], Tan H,Zhang S,Liu H,Peng W,Li R,Gu Y,Wang X,Mao J,Shen X, Imaging findings in phyllodes tumors of the breast. Therefore, close follow-up is required. A 48-year-old woman was admitted with an 8-year history of right breast mass. 2021 Nov 25;10668969211060482. doi: 10.1177/10668969211060482. 2012 Jan; [PubMed PMID: 21353414], Liberman L,Bonaccio E,Hamele-Bena D,Abramson AF,Cohen MA,Dershaw DD, Benign and malignant phyllodes tumors: mammographic and sonographic findings. 10.1097/00000478-200303000-00007. Its histological diagnosis is based on the criteria established by the AFIP. In addition to epithelial cells from the ducts and lobules, phyllodes tumors can also contain stromal cells. 1994, 18: 720-727. 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