Mezi S, Pallotta M, Filippini A, Custureri F, Modesti M
Istituto di III Clinica Chirurgica Generale e Terapia Chirurgica, Università degli Studi La Sapienza, Roma.
G Chir. 1992 Aug-Sep;13(8-9):413-7.
The Authors report 4 cases very interesting for the differential diagnosis of phyllodes tumor, a breast tumor with a mainly local malignant potential. Such tumor, although presenting histologic, clinical and instrumental features which allow for a presumptive pre-surgical diagnosis, often has characteristics comparable to other breast pathologies with a different natural history. The Authors, after analyzing clinical, mammographic, echographic and histologic features of the tumor, suggest the most appropriate therapy for the local control of the lesion. Surgical excision should be carried at least 1 cm deep into the normal tissue to prevent local relapse related to an incomplete enucleation: in fact, the tumor is only apparently capsulated. Furthermore, the Authors believe a patients must undergo, after primary surgery, an adequate instrumental and clinical follow up for the early diagnosis of commonly occurring relapses.
作者报告了4例在叶状肿瘤鉴别诊断方面非常有趣的病例，叶状肿瘤是一种主要具有局部恶性潜能的乳腺肿瘤。这种肿瘤虽然具有组织学、临床和影像学特征，有助于术前初步诊断，但往往具有与其他自然病程不同的乳腺病变相似的特征。作者在分析了肿瘤的临床、乳腺X线摄影、超声和组织学特征后，提出了对病变进行局部控制的最合适治疗方法。手术切除应至少深入正常组织1厘米，以防止因摘除不完全而导致局部复发：事实上，肿瘤只是表面有包膜。此外，作者认为患者在初次手术后必须接受充分的影像学和临床随访，以便早期诊断常见的复发情况。
