den Exter Paul L, Hornstra Bonne J, Vree Robbert
Diaconessenhuis, afd. Chirurgie, Leiden, The Netherlands.
Ned Tijdschr Geneeskd. 2009;153:A981.
A 40-year-old woman presented at the breast outpatient clinic with a giant tumour of her left breast. The size, rapid growth and radiological characteristics of the lesion led us to suspect a phyllodes tumour. A histological examination of a needle biopsy confirmed this diagnosis. An additional CT scan revealed no signs of metastases. We performed a mastectomy during which a tumour measuring 48 x 33 x 25 cm was resected. Histological examination revealed a borderline phyllodes tumour. Phyllodes tumours are rare fibroepithelial neoplasms of the breast and pre-operatively these are often difficult to differentiate from fibroadenomas. Phyllodes tumours have a variable clinical course with the ability to metastasize and a propensity to recur locally. Complete excision with wide margins is essential to prevent local recurrence. In our case, the surgical margins were limited and our patient was therefore treated with postoperative radiation therapy.
一名40岁女性因左乳巨大肿瘤就诊于乳腺门诊。病变的大小、快速生长及影像学特征使我们怀疑为叶状肿瘤。针吸活检的组织学检查证实了这一诊断。进一步的CT扫描未发现转移迹象。我们进行了乳房切除术，术中切除了一个大小为48×33×25 cm的肿瘤。组织学检查显示为交界性叶状肿瘤。叶状肿瘤是乳腺罕见的纤维上皮性肿瘤，术前常难以与纤维腺瘤鉴别。叶状肿瘤临床过程多变，有转移能力且易局部复发。广泛切缘完整切除对于预防局部复发至关重要。在我们的病例中，手术切缘有限，因此我们的患者接受了术后放射治疗。
