Hart J, Layfield L J, Trumbull W E, Brayton D, Barker W F, Giuliano A E
Department of Pathology, UCLA 90024.
Arch Surg. 1988 Sep;123(9):1079-83. doi: 10.1001/archsurg.1988.01400330055008.
Thirty-five cases of benign cystosarcoma phyllodes, 13 cases of malignant cystosarcoma phyllodes, and ten cases of giant fibroadenoma were studied. The diagnosis of benign or malignant cystosarcoma phyllodes was based on a combination of histological features. Clinical and gross pathologic findings were not found to be useful in distinguishing between benign and malignant tumors. Giant fibroadenomas occurred primarily in black adolescents and were histologically distinct. Positive surgical margins were found to be the best predictor of local recurrence of benign or malignant cystosarcoma phyllodes. Systemic metastases occurred in only one case of malignant cystosarcoma phyllodes. Most benign and malignant cystosarcoma phyllodes may be treated by wide local excision with tumor-free margins. Giant fibroadenomas should be treated by simple excision to preserve normal breast tissue.
对35例良性叶状囊肉瘤、13例恶性叶状囊肉瘤和10例巨大纤维腺瘤进行了研究。良性或恶性叶状囊肉瘤的诊断基于组织学特征的综合判断。临床和大体病理表现对于区分良性和恶性肿瘤并无帮助。巨大纤维腺瘤主要发生于黑人青少年，在组织学上有明显特征。手术切缘阳性被认为是良性或恶性叶状囊肉瘤局部复发的最佳预测指标。仅1例恶性叶状囊肉瘤发生了全身转移。大多数良性和恶性叶状囊肉瘤可通过切缘无肿瘤的广泛局部切除进行治疗。巨大纤维腺瘤应通过单纯切除以保留正常乳腺组织。
