Article

Invasive ductal breast cancer within a malignant phyllodes tumor: case report and assessment of clonality

Institute of Pathology, Heidelberg University, 69120 Heidelberg, Germany.
Human pathology (Impact Factor: 2.81). 11/2009; 41(2):293-6. DOI: 10.1016/j.humpath.2009.08.006
Source: PubMed

ABSTRACT Invasive carcinomas arising within fibroepithelial tumors represent an uncommon manifestation of breast cancer. We report the case of a 70-year-old woman who underwent mastectomy for a malignant phyllodes tumor measuring 6 cm. Histological workup of the specimen revealed a high-grade invasive ductal carcinoma 2.5 cm in diameter within the phyllodes tumor. DNA was isolated from microdissected epithelial and stromal components of the phyllodes tumor as well as from the invasive ductal carcinoma cells. Using multiplex polymerase chain reaction, a comparative allelotyping was performed with a panel of 11 microsatellite markers. The malignant stroma of the phyllodes tumor showed loss of heterozygosity at chromosome 16q23, 17q12, 17q25, and 22q13; the epithelial tumor component shared the loss of 16q23; whereas the invasive carcinoma had lost divergent alleles at 16q23, 17q12, and 17q25, indicating a lack of clonality between phyllodes tumor and invasive ductal carcinoma. Although our data are compatible with a previously postulated common origin of epithelial and stromal components of phyllodes tumors, the coexisting invasive ductal carcinoma appears to represent a true collision tumor.

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    ABSTRACT: There have been some reports of coincidentalpresentation of breast carcinoma and phyllodes tumor in the same breast. Most of the cases were carcinoma that arose from a phyllodes tumor with a histologically identified transitional area, and they behaved less aggressively than the usually encountered carcinoma. Collision tumors are rare clinical entities in which two histologically distinct tumor types show involvement at the same site. The occurrence of these tumors in the breast is extremely rare. Here, we report a case of 45-year-old woman who had both invasive ductal carcinoma as the finding of inflammatory carcinoma and a malignant phyllodes tumor in the same breast. There was no evidence of a transitional area between the phyllodes tumor and the invasive ductal carcinoma. To our knowledge, this is the first report of a collision tumor of inflammatory breast carcinoma coincident with a malignant phyllodes tumor in same breast.
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    ABSTRACT: Phyllodes tumors are extremely uncommon neoplasms that are usually benign. Patients with phyllodes tumors typically present with a well-circumscribed, painless, firm, and mobile mass or nodule characterized by rapid growth in a short period of time. It is recommended that these tumors be excised even though it may look as a fibroademoma. Our patient presented with a left nipple mass with rapid growth. The patient had been previously diagnosed with malignant phyllodes tumor, which was excised with adequate margins, later presenting with an exophytic mass extending from the nipple along with bloody discharge. The patient underwent a complete mastectomy of the left breast without a lymph node dissection, and pathology revealed an additional focus of intramammary myoepithelioma. The aim of this case report is increase awareness of these tumors and their potentially unusual presentations to allow clinicians the ability to recognize these neoplasms earlier as well as recognizing the need for better adjuvant therapy.
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    ABSTRACT: Phyllodes tumor (PT) is an uncommon tumor of female breast. The tumor clinically, radiologically, cytologically as well as histologically can mimic fibroadenoma which is a common tumor of fibroepithelial group. Ductal carcinoma in situ (DCIS) in the epithelial component of PT is very rare. We report a rare case of intermediate grade DCIS arising in a benign PT in a 42-year-old lady. The patient presented with a small nodule in right breast along with serosanguineous discharge from nipple. Ultrasonography and cytology failed to distinguish between fibroadenoma and PT. Histopathological examination following wide local excision displayed the biphasic tumor comprising of benign looking cellular stroma and epithelial lining. It also demonstrated the foci of intermediate grade DCIS without any invasive component. Considering the clinicoradiological profile along with histopathological features, the diagnosis of DCIS in a benign PT of breast was made.
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