Sin Eliza I-Lin, Wong Chow Yin, Yong Wei Sean, Ong Kong Wee, Madhukumar Preetha, Tan Veronique Kiak Mien, Thike Aye Aye, Tan Puay Hoon, Tan Benita Kiat Tee
Department of General Surgery, Singapore General Hospital, Singapore, Singapore.
Singhealth Duke-NUS Breast Centre, Singapore General Hospital, Singapore, Singapore Division of Surgical Oncology, National Cancer Centre Singapore, Singapore, Singapore.
J Clin Pathol. 2016 Apr;69(4):364-9. doi: 10.1136/jclinpath-2015-203475. Epub 2015 Dec 15.
Malignant transformation of the epithelial component of phyllodes tumours (PT) is rare and only reported in literature as sporadic cases of carcinoma associated with PTs. We report the clinicopathological characteristics of in situ and invasive carcinoma coexisting with PT in 10 patients treated in our institution over an 11-year period from 1992 to 2012. Ten patients with coexisting PT and in situ or invasive carcinoma were identified from our records. Six had carcinoma found within the PT. All were female with a median age of 47 (43-72) years. One patient had a history of PT in the same breast while another had a history of PT in the same breast as well as invasive ductal carcinoma in the contralateral breast. The rest did not have any risk factors of breast cancer. Five patients had a preoperative core needle biopsy performed with the report of a fibroepithelial lesion. The rest of the patients had surgery upfront for their breast masses. Two patients who had ER/PR positive invasive carcinoma received adjuvant hormonal therapy. Patients were followed up for a mean of 3.6 years (9 months-10 years) and all patients were alive and recurrence free. PT associated with carcinoma is rare, and we present a series of cases that add to the limited current literature. It is often difficult to detect the presence of the carcinomatous component preoperatively. Hence, close examination of resected PT specimens must be carried out to allow prompt detection of any associated carcinomas, however rare, such that adequate treatment can be given.
叶状肿瘤（PT）上皮成分的恶性转化很少见，仅在文献中报道为与PT相关的散发性癌病例。我们报告了1992年至2012年在我们机构接受治疗的10例患者中，原位癌和浸润性癌与PT共存的临床病理特征。从我们的记录中确定了10例PT与原位或浸润性癌共存的患者。6例在PT内发现癌。所有患者均为女性，中位年龄47（43 - 72）岁。1例患者同侧乳房有PT病史，另1例患者同侧乳房有PT病史且对侧乳房有浸润性导管癌病史。其余患者无任何乳腺癌危险因素。5例患者术前行粗针穿刺活检，报告为纤维上皮性病变。其余患者因乳房肿块直接接受手术。2例雌激素受体/孕激素受体（ER/PR）阳性浸润性癌患者接受了辅助激素治疗。患者平均随访3.6年（9个月 - 10年），所有患者均存活且无复发。与癌相关的PT很少见，我们报告了一系列病例，增加了目前有限的文献资料。术前通常很难检测到癌成分的存在。因此，必须对切除的PT标本进行仔细检查，以便及时发现任何相关的癌，无论多么罕见，从而能够给予充分的治疗。
