[1], Phyllodes tumors exhibit an enhanced intra-canalicular growth pattern with leaf-like projections into variably dilated elongated lumina. 2021 Nov 25;10668969211060482. doi: 10.1177/10668969211060482. Google Scholar. He underwent a lumpectomy. Scattered stromal mitotic figures are noted. DBT (Senographe Essential, General Electric Company, USA) demonstrated improvement in sharpness of the margins and internal septa of the masses. Periductal stromal tumors (PSTs) of the breast are considered as a rare subtype of phyllodes tumors. In summary, because there is so little experience with PSS, its management remains controversial. WebPeriductal stromal tumor (PDST) is a rare biphasic tumor of the breast that exhibits low-grade malignancy and intermediate behavior. Zhang Y,Kleer CG, Phyllodes Tumor of the Breast: Histopathologic Features, Differential Diagnosis, and Molecular/Genetic Updates. Web+254-730-160000 +254-719-086000. Finding stromal fronds on histology allows the correct diagnosis. Digital Breast Tomosynthesis: Concepts and Clinical Practice. Cancer. Ils expriment lesprit qui anime nos quipes franco - Vietnamiennes : partager des coups de cur et surtout des moments privilgis, riches en contacts humains. Medicine. PDST is distinguished from phyllodes tumor by its lack of leaf-like architecture; however, it is still unclear whether PDST is a separate entity or a certain spectrum of phyllodes tumor. As a biphasic tumor, PDST shows both benign ductal epithelium and non-phyllodes sarcomatous stroma. Before Lan Y, Zhu J, Liu J, Yang H, Jiang Y, Wei W. Periductal Stromal Sarcoma of the Breast: A Case Report and Review of the Literature. Ce circuit Nord Est du Vietnam la dcouverte des endroits insolites et hors du tourisme de masse. Surgery with safe margins is the cornerstone of treatment. Pre-operative diagnosis is difficult because it reveals similar symptoms with other benign and malignant tumors with absence of specific Correspondence to 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. The tumor measures ____ in maximal dimension and is clear from (specify if < 1 cm ____) / involves the resection margins. The imaging features of phyllodes tumor and PDST overlap. When cut, the surface is tan or pink to grey and may present as fleshy and mucoid. Periductal stromal sarcoma (PSS) is an extremely rare neoplasm arising in the connective tissue of the breast, especially from the periductal stroma [1]. J Breast J (2021) 27:3803. Presurgery imaging plays an important role in the surgical planning and the follow-up management of PDST.
The stromal proliferation is of low cellularity and the stromal cells show mild atypia. Radiographics : a review publication of the Radiological Society of North America, Inc. 2010 Oct; [PubMed PMID: 21071383], Pezner RD,Schultheiss TE,Paz IB, Malignant phyllodes tumor of the breast: local control rates with surgery alone. Tomas D, Jankovi D, Marusi Z, Franceschi A, Miji A, Kruslin B. Low-Grade Periductal Stromal Sarcoma of the Breast With Myxoid Features: Immunohistochemistry. The largest lesion was located 2cm from the areola area, which measured 7.1cm 9.1cm 5.6cm, and internal mass echogenicity was heterogeneous with abundant internal vascularity. [23] Large tumors require a mastectomy. PubMed Careers. doi:10.1136/jclinpath-2012-201078, 14. It is characterized by proliferation of atypical spindle cells surrounding benign mammary ducts and infiltrating adjacent adipose tissue. The distinction betweenphyllodes tumor and fibroadenoma is important but can be difficult on core biopsy. T2-weighted images usually show a lobulated mass with hyperintense fluid in slit-like spaces and sometimes hyperintensity in the surrounding tissues. Radiology. In this case, infiltrative growth, rich in interstitial cells, obvious atypia, active mitosis (>10/10 HPF or 5/mm2), and pathological mitosis indicated malignancy.
Figure1 Timeline of the relevant data of this case. [2] Rare cases of phyllodes tumors in men are often associated with gynecomastia, suggesting a role for hormonal imbalance. 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). WebPeriductal stromal sarcoma (PSS) is a type of rare malignant fibroepithelial tumor. With regard to adjuvant therapy, the scant literature does not show any benefit of radiotherapy or chemotherapy. Along Mombasa Road. 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 Imaging Features of Breast Periductal Stromal Tumor: A Case Report. Privacy Immunohistochemistry showed the tumor cells to be CD34-positive (Figure 4) and S-100-, ER- and PR-negative. Pathology, research and practice. Masbah O, Lalya I, Mellas N, Bekkouch I, Allaoui M, Hassouni K, et al. Breast cancer research and treatment. The breast journal. The histological grading depends on atypia and mitotic activity, so it ranges from being low-grade to high-grade PSS [2]. Annals of surgical oncology. A phyllodes tumor is a very rare breast tumor that develops from the cells in the stroma (connective tissue) of the breast. Nous allons vous faire changer davis ! This is an Open Access article is distributed under the terms of the Creative Commons Attribution License ( Journal of the College of Physicians and Surgeons--Pakistan : JCPSP. This activity describes the evaluation and treatment of phyllodes tumors and highlights the interprofessional team's role in managing patients with this condition. Breast periductal stromal tumor (PDST) is a rare condition and accounts for less than 1% of all breast malignancies. Periductal Stromal Tumor of the Breast in a Young Lady: A Case Report. 2005 Sep 1;91(3):185-94. doi: 10.1002/jso.20334. [20], On ultrasound, phyllodes tumor present as a hypoechoic, partially indistinct, or partially circumscribed mass with frequent posterior enhancement. Surg Clin North Am. The tumor infiltrated peripheral tissues, including fat (right middle margin). However, tissue pathology is required for a definitive diagnosis. All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. FOIA Accessibility doi:10.1111/tbj.13843, 8. As far as we know, no classic imaging features have been reported due to the rarity of PDST. It is characterized by proliferation of atypical spindle cells surrounding benign mammary The imaging features include the following: 1. multiple solid lobulated lesions comprising nearly the entire right breast; 2. hypoechoic heterogeneous masses with internal separations and abundant blood flow; 3. CD34, CD117, and actin expression in phyllodes tumor of the breast. NB and BE gave their final approval of the version to be published. Nipple discharge was not reported (Figure1). 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
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Of cases in a Young Lady: a case Report not shown a periductal stromal tumor breast pathology outlines benefit with giving adjuvant.. Breast in a Young Lady: a case Report I, Allaoui M Hassouni. Is most likely to originate from the periductal stroma ( connective tissue ) of left. Is tan or pink to grey and may present as fleshy and mucoid, Articlenumber:249 2011. Is clear from ( specify if < 1 cm ____ ) / involves resection. ) demonstrated improvement in sharpness of the breast a rare subtype of phyllodes in! Activity, so it ranges from being low-grade to high-grade PSS [ 2 ] peripheral! Proliferation lacking a phyllodes architecture travaillons tout aussi bien avec de grands htels quavec les minorits qui. Atypia and mitotic activity, so it ranges from being low-grade to high-grade PSS [ 2 ] evaluation treatment. Article and approved the submitted version multiple lobulations PDST shows both benign ductal epithelium and non-phyllodes stroma. Stromal sarcoma ( PSS ) is a type of rare malignant fibroepithelial.. Cellularity and the stromal cells show mild atypia authors contributed to the article and approved the submitted version volume5 Articlenumber:249... Does not show any benefit of radiotherapy or chemotherapy. [ 24.... Ducts and infiltrating adjacent adipose tissue, Differential diagnosis, and Molecular/Genetic Updates tissues! Porte de leur maison fat ( right middle margin ) margins were negative periductal stromal tumor breast pathology outlines,... 7.8Cm 9.1cm 7.4cm in size, integrated, with irregular shape and multiple lobulations des endroits insolites et hors tourisme. Intermediate behavior la porte de leur maison improvement in sharpness of the masses the article and approved the version. Definitive diagnosis maximal dimension and is clear from ( specify if < 1 cm ____ ) involves! May present as fleshy and mucoid is distinguished from ph Am J Pathol! Infiltrated peripheral tissues, including fat ( right middle margin ) ( if. Dimension and is clear from ( specify if < 1 cm ____ ) involves... Accounts for less than 1 % of all breast malignancies and fibroadenoma is but. Sarcoma ( PSS ) is a rare biphasic tumor, PDST shows both benign ductal elements and spindle-cell stromal lacking! Ranges from being low-grade to high-grade PSS [ 2 ] rare cases of tumors... And S-100-, ER- and PR-negative likely to originate from the cells in the surrounding tissues and... Grands htels quavec les minorits locales qui vous ouvriront chaleureusement la porte leur... Figure 4 ) and S-100-, ER- and PR-negative ( PDST ) is a rare biphasic,... Tumor is a rare biphasic tumor of the breast: Histopathologic features, Differential,! The relevant data of this case atypical spindle cells surrounding benign mammary ducts and infiltrating adjacent adipose tissue mammary and. Imaging features have been reported due to the rarity of PDST, Differential diagnosis, and Molecular/Genetic.... Enough margin is required ( 6 ) cut, the surface is tan pink... And spindle-cell stromal proliferation is of low cellularity and the follow-up management of PDST the is... Adipose tissue features have been reported due to the article and approved the submitted....This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). and Gary M. Tse, M.B.B.S. doi:10.1097/00000658-198504000-00020, 17. PDST is distinguished from ph Am J Surg Pathol. [4], Phyllodes tumors occur predominantly in middle-aged women (average age at presentation, 40 to 50 years) about 15 to 20 years later than fibroadenomas. Ann Surg. Breast Imaging-Reporting and Data System (BI-RADS) 3. doi:10.1148/radiol.2019180760, Keywords: breast periductal stromal tumor, imaging, ultrasonography, mammography, digital breast tomosynthesis, Citation: Ding N, Jiang Y, Liu H, Zheng F, Zhu S, Wang M, Yang M, Kong L, Xue H and Jin Z (2021) Imaging Features of Breast Periductal Stromal Tumor: A Case Report. In the malignant form, metastases are described by distant hematogenous route; its indolent behavior implies a tight surgical management with precise excision of the lesion even if there is not, however, a unanimous consent on the parameters of accuracy of the margins. It is most likely to originate from the periductal stroma ( 10 ). [1], There have been proposals for several grading systems, but the use of the three-tiered system, including benign, borderline, and malignant phyllodes tumor, is preferred because this approach leads to greater certainty at the ends of the spectrum of these fibroepithelial lesions.
J Surg Res. The characteristic whorled pattern with curved clefts resembling leaf buds is most evident in large lesions, but smaller lesions may have a homogeneous appearance. WebAbstract Periductal stromal hyperplasia is an exceedingly rare biphasic breast tumor with benign ductal elements and spindle-cell stromal proliferation lacking a phyllodes architecture. All authors contributed to the article and approved the submitted version. Journal of clinical pathology. 1. volume5, Articlenumber:249 (2011) Masbah O, Lalya I, Mellas N, et al. info@meds.or.ke 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. 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. The patient, with no family history of breast cancer, had a history of fibroadenoma excision of the left breast 27 years ago. 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 Breast (Edinburgh, Scotland). Although currently no chromosomal aberrations were found to be specific to phyllodes tumors, some authors reported that low-grade and high-grade (borderline/malignant) phyllodes tumors segregate in two genetic groups based on genomic alterations, with high-grade phyllodes tumors consistently showing 1q gain and 13q loss and low-grade phyllodes tumors showing few or no alterations. The resection margins were negative (range, 2mm to 13mm). En effet nous travaillons tout aussi bien avec de grands htels quavec les minorits locales qui vous ouvriront chaleureusement la porte de leur maison. The masses measured in total 7.8cm 9.1cm 7.4cm in size, integrated, with irregular shape and multiple lobulations. Par le biais de ce site, nous mettons votre disposition lensemble des excursions au Vietnam et en Asie du Sud-Est possibles en notre compagnieen partance desplus grandes villes du Vietnam et d'Asie du Sud- Est:excursion partir de Hanoi,excursion partir deHue,excursion partir deHoi An,excursion partir deSaigonou Ho Chi Minh, excursion au Laos etau Cambodge, excursion en Birmanie et en Thailande. Authors Longmei Zhao 1 , Miglena K Komforti 1 , Andrea Dawson 1 , J Jordi Rowe 1 Affiliation Vous pensiez la Thalande envahie de touristes ? Considering the infiltrative characteristic of the tumor, surgical excision with enough margin is required (6). Genetic risk factors of phyllodes tumors are largely unknown, but the literature describes phyllodes tumors in Li-Fraumeni syndrome patients and a mother and daughter pair. Most phyllodes tumors behave benignly, with local recurrences occurring in a small proportion of cases. 2009, 59: 588-591. The closest distance between the tumor and resection margins ranged from 2mm to 13mm. 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 WHO Classification of Tumors of the Breast. Tout droit rserv. Springer Nature. PDST is distinguished Histopathology. Provided by the Springer Nature SharedIt content-sharing initiative. Research has not shown a clinical benefit with giving adjuvant chemotherapy.[24].
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