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儿童良性叶状肿瘤:8 例病例研究及文献复习。

Benign Phyllodes Tumor in Children: A Study of 8 Cases and Review of the Literature.

机构信息

Department of Pathology and Laboratory Medicine, Hartford Hospital, Hartford, CT.

出版信息

J Pediatr Hematol Oncol. 2020 Jul;42(5):e388-e391. doi: 10.1097/MPH.0000000000001501.

Abstract

Phyllodes tumor (PT) occurs predominantly in middle-aged women, and although its occurrence in young women, adolescents, and even children is documented, presentation in the pediatric population has been the least well studied because of its rarity. Incompletely defined in children with PT are recurrence rates and optimal surgical management. We retrospectively studied the pathology database of Hartford Hospital from 2010 to 2017 to find all cases of PT in patients 18 years of age or younger. A series of 8 children/adolescents with breast masses diagnosed as benign PT were identified. Patients were 14 to 16 years of age (mean 15.2 y) and tumor size ranged from 2.2 to 7.2 cm (mean 4.4 cm). Both breasts were equally affected. All patients were treated with excision, tantamount to simple enucleation in most cases, and positive or "tumor-abutting" margins were universal. Mean follow-up after surgery was 27.5 months, during which time a single recurrence (at 9 mo) became manifest, which was re-excised and again showed benign PT. There were no pathologic features (including marginal status) that could have predicted the sole recurrence. Despite positive margins, the local recurrence rate for pediatric benign PT appears acceptably low (1 in 8 cases) such that reflex re-excision is probably unnecessary.

摘要

叶状肿瘤(PT)主要发生于中年女性,尽管有文献报道其也可见于年轻女性、青少年,甚至儿童,但由于其罕见,儿科人群中的发病情况研究最少。儿童 PT 患者的复发率和最佳手术治疗方法尚未完全明确。我们回顾性研究了 2010 年至 2017 年哈特福德医院的病理数据库,以寻找所有 18 岁及以下患者的 PT 病例。确定了 8 例儿童/青少年乳房肿块诊断为良性 PT 的患者。患者年龄为 14 至 16 岁(平均 15.2 岁),肿瘤大小为 2.2 至 7.2cm(平均 4.4cm)。双乳均受影响。所有患者均接受了切除治疗,在大多数情况下相当于单纯剜除,且均为阳性或“肿瘤毗邻”切缘。术后平均随访 27.5 个月,期间有 1 例(9 个月)单发复发,再次切除后仍显示为良性 PT。没有任何病理特征(包括切缘状态)可以预测唯一的复发。尽管存在阳性切缘,但儿科良性 PT 的局部复发率似乎较低(8 例中有 1 例),因此可能不需要反射性再次切除。

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