Abstract
A 43-year-old woman presented with a right breast lump that had enlarged over 5 months. She had chemoradiotherapy for non-Hodgkin's lymphoma in 1989. Histology revealed a malignant phyllodes tumour (PT) with liposarcomatous differentiation and ductal carcinoma in situ (DCIS) within the tumour with invasive tubular carcinoma, DCIS, and lobular carcinoma in situ in the surrounding breast. She had surgery and adjuvant radiotherapy. One year follow-up showed no recurrence or metastatic disease. Liposarcomatous differentiation is uncommon in PTs, and coexisting carcinoma is rare with 38 cases in 31 reports in the literature. Carcinoma is reported in malignant (n = 19), benign (n = 16) and in borderline PTs (n = 3) with invasive carcinoma (n = 18) and pure in situ carcinoma (n = 19) recorded in equal frequency. Carcinoma is more commonly found within the confines of benign PTs; whereas it is more often found surrounding the PT or in the contralateral breast in malignant PTs. Previous radiotherapy treatment is reported in only two cases. The aetiology of co-existing carcinoma is unclear but the rarity of previous radiotherapy treatment suggests that it is incidental. This case highlights the diverse pathology that can occur with PTs, which should be considered when evaluating pathology specimens as they may impact on patient management.
Highlights
Phyllodes tumors (PTs) of the breast are uncommon biphasic fibroepithelial neoplasms that account for
We present a case of a malignant PT that contained heterologous liposarcomatous stromal differentiation and exhibited a range of epithelial pathology
The invasive tumour was adjacent to a small duct with morphological features of low-grade Ductal carcinoma in situ (DCIS) but there was no morphological transition between invasive carcinoma and the stromal or epithelial components of the adjacent PT
Summary
Phyllodes tumors (PTs) of the breast are uncommon biphasic fibroepithelial neoplasms that account for
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