Christensen Lene Gaarsmand, Di Caterino Tina, Talman Maj-Lis
Department of Pathology, Odense University Hospital, Odense, Denmark.
Department of Pathology, Copenhagen University Hospital, Rigshospitalet, København Ø, Denmark.
APMIS. 2019 Jun;127(6):484-488. doi: 10.1111/apm.12949. Epub 2019 Apr 11.
Phyllodes tumors (PTs) are rare fibroepithelial neoplasms of the breast and constitute 0.3-1% of all primary breast tumors. They should be characterized in to a benign, borderline or malignant category based on a combination of histological features. PTs can show heterologous components, typically sarcomatous, including osteosarcomatous and chondrosarcomatous. Benign heterologous components are exceedingly rare with only one prior reported case in the English literature. This case emphasizes how difficult establishing a correct diagnosis in PTs with heterologous components can be, especially when the tumor consists mainly of a benign heterologous component. We report the case of a 65 year old woman with a recurrent breast tumor initially misdiagnosed as benign osseous metaplasia. The tumor re-occurred as a malignant PT dominated by benign osseous and chondroid metaplasia. Multiple metastases consisting of primarily mature bone and cartilage were seen in the lungs. On microscopic revision and considering the clinical course the primary breast tumor was re-classified as a borderline PT.
叶状肿瘤（PTs）是一种罕见的乳腺纤维上皮性肿瘤，占所有原发性乳腺肿瘤的0.3 - 1%。应根据组织学特征的组合将其分为良性、交界性或恶性类别。PTs可表现出异源性成分，通常为肉瘤样，包括骨肉瘤样和软骨肉瘤样。良性异源性成分极为罕见，英文文献中仅有一例先前报道的病例。该病例强调了在伴有异源性成分的PTs中做出正确诊断有多困难，尤其是当肿瘤主要由良性异源性成分组成时。我们报告了一例65岁女性复发性乳腺肿瘤的病例，最初被误诊为良性骨化生。肿瘤复发为以良性骨和软骨化生为主的恶性PT。肺部可见多处主要由成熟骨和软骨组成的转移灶。经显微镜复查并结合临床病程，原发性乳腺肿瘤被重新分类为交界性PT。
