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妊娠期间乳腺恶性叶状肿瘤的致命结局:1例病例及文献综述

Fatal outcome of malignant phyllodes tumor of the breast in pregnancy: a case and literature review.

作者信息

Zhang Wen-Xiang, Kong Xiang-Yi, Zhai Jie, Fang Yi, Song Yan, Wang Jing

机构信息

Department of Breast Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

Department of Pathology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

出版信息

Gland Surg. 2021 Jan;10(1):371-377. doi: 10.21037/gs-20-538.

Abstract

Phyllodes tumor of the breast (PTB) is a rare fibroepithelial breast neoplasm that accounts for less than 1% of breast tumors. Only a few cases related to pregnancy have been reported. It is not known how pregnancy affects the diagnosis, treatment and prognosis of breast tumors. Here we report a case of a 38-year-old female patient with a small, mobile palpable lump in the left breast for about 15 years. it was considered a benign lesion and no surgical treatment was performed at the beginning. The left breast mass became larger suddenly during pregnancy, However, she did not see the doctor and receive any treatment in time. The lump was resected one year after labor and confirmed to be malignant phyllodes of the breast by histopathology and immunohistochemistry. Unfortunately, local recurrence occurred within six months after the first operation, and lung metastasis occurred eight months later. And this patient finally died 13 months after the operation due to tumor progression. This is the first report of pregnancy-related malignant PTB, with local recurrence and distant metastasis in a short period. This case report highlights a situation: the patient should be diagnosed early and treated in time when she has a previous breast fibroadenoma, but suddenly increased during pregnancy.

摘要

乳腺叶状肿瘤(PTB)是一种罕见的乳腺纤维上皮性肿瘤,占乳腺肿瘤的比例不到1%。仅有少数与妊娠相关的病例报道。目前尚不清楚妊娠如何影响乳腺肿瘤的诊断、治疗及预后。在此,我们报告一例38岁女性患者,其左乳可触及一个小的、可活动的肿块约15年。起初它被认为是良性病变,未进行手术治疗。该患者在妊娠期间左乳肿块突然增大,然而,她未及时就医及接受任何治疗。产后一年切除肿块,经组织病理学和免疫组化证实为乳腺恶性叶状肿瘤。不幸的是,首次手术后6个月内出现局部复发,8个月后发生肺转移。该患者最终在术后13个月因肿瘤进展死亡。这是首例与妊娠相关的恶性PTB且短期内出现局部复发和远处转移的报道。本病例报告突出了一种情况:既往有乳腺纤维腺瘤但在妊娠期间突然增大的患者应尽早诊断并及时治疗。

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