Phyllodes tumor: Difference between revisions

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#REDIRECT [[Breast cancer]]
{{SI}}                                                                     
{{CMG}} {{AE}} {{MV}}
{{SK}} Cystosarcoma phyllodes;
==Overview==
 
'''Phyllodes tumor''' (also known as ''cystosarcoma phyllodes''), is a typically large, fast-growing mass that arises from the periductal [[stromal cell]]s of the [[breast]]. Phyllodes tumors account for less than 1% of all breast [[Neoplasia|neoplasms]].
 
==Historical Perspective==
*Phyllodes tumor was first discovered by Johannes Muller, a German physician in 1838.
 
==Classification==
*Phyllodes tumor may be classified according to histological grade into 3 subtypes:
:*Benign
:*Borderline
:*Malignant
 
==Pathophysiology==
*The pathogenesis of phyllodes tumor is characterized by the overgrowth of stromal cells. 
*Phyllodes tumor arises from the periductal [[stromal cell]]s of the [[breast]], which are normally involved in the supportive function of the parenchymal tissue.
*Genes involved in the development of phyllodes tumor, include:
:*
:*
*On gross pathology, characteristic findings of phyllodes tumor, include:
:*Cleft/leaf-like structures
:*Friable mass
:*Well-defined margins
*On microscopic histopathological analysis,characteristic findings of phyllodes tumor, include:
:*Large slit-like spaces
:*Cellular myxoid stroma
:*Infiltrative border
:*Stromal overgrowth
 
==Causes==
* There are no established causes for phyllodes tumor.
 
==Differentiating Phyllodes Tumor from Other Diseases==
*Phyllodes tumor must be differentiated from other diseases that cause a breast mass, such as:
:*Juvenile fibroadenoma
:*Breast abscess
:*Adenocarcinoma
:*Mastitis
 
==Epidemiology and Demographics==
*The prevalence of phyllodes tumor is approximately 0.05 per 100,000 individuals worldwide.
*Approximately 6% of all phyllodes tumors are malignant.
*Phyllodes tumor accounts for less than 0.3-1% of all breast neoplasms
===Age===
*Patients of all age groups may develop phyllodes tumor.
*However, phyllodes tumor is more commonly reported in adult women between 40 and 60 years.
===Gender===
*Females are more commonly affected with phyllodes tumor than males. 
===Race===
*There is no racial predilection for phyllodes tumor.
 
==Risk Factors==
*Common risk factors in the development of phyllodes tumor, include:
 
== Natural History, Complications and Prognosis==
*The majority of patients with phyllodes tumor remain asymptomatic for years.
*The most important early clinical feature is a rapid growing palpable mass.
*If left untreated, the minority of patients with phyllodes tumor may progress to develop metastases.
*Complications of phyllodes tumor are usually related to surgery (mastectomy).
*Common complications, include:
:*Infection
:*Seroma formation
:*Local or distant recurrence
*Prognosis is generally poor, and the 5 year survival rate of patients with phyllodes tumor is approximately
 
== Diagnosis ==
===Diagnostic Criteria===
*The diagnosis of phyllodes tumor is made with biopsy.
=== Symptoms ===
*Phyllodes tumor is usually asymptomatic.
*There are no remarkable symptoms of phyllodes tumor.
 
=== Physical Examination ===
*Patients with phyllodes tumor usually appear [general appearance].
*Breast physical examination may be remarkable for:
*Breast mass, with the following characteristics:
:*Firm
:*Mobile
:*Well-circumscribed
:*Non-tender
 
=== Laboratory Findings ===
*There are no specific laboratory findings associated with phyllodes tumor.
 
===Imaging Findings===
*[Imaging study 1] is the imaging modality of choice for phyllodes tumor.
*On [imaging study 1], findings of phyllodes tumor include:
 
== Treatment ==
=== Medical Therapy ===
*There is no medical therapy for phyllodes tumor.
 
=== Surgery ===
*Surgery is the mainstay of therapy for phyllodes tumor.
*Wide local excision is the most common approach to the treatment of phyllodes tumor.
 
=== Prevention ===
*Effective measures for the primary prevention of phyllodes tumor include periodical self-breast examination, and routine mammography. 
*Once diagnosed and successfully treated, patients with phyllodes tumor are followed-up periodically.
*Follow-up testing, includes: ultrasound examination.
 
==References==
{{Reflist|2}}
[[Category:Oncology]]

Latest revision as of 17:56, 12 March 2019

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