Brahmachari Swagata, Kumari Meena, Sharma Tanya, Jagtap Maheshkumar B
Surgery, All India Institute of Medical Sciences, Bhopal, Bhopal, IND.
General Surgery, All India Institute of Medical Sciences, Bhopal, Bhopal, IND.
Cureus. 2022 Mar 16;14(3):e23225. doi: 10.7759/cureus.23225. eCollection 2022 Mar.
Phyllodes tumor (PT) is a rare benign tumor of the breast with a propensity to recur and metastasize. Ductal carcinoma in situ (DCIS) within PT is an extremely rare finding and is usually diagnosed postoperatively. We present a case of a 36-year-old female with a recurrent lump in her left breast diagnosed as a benign PT. Preoperatively, aspiration cytology revealed DCIS within the known case of recurrent PT. Emergency left modified radical mastectomy was performed due to an uncontrolled sudden hemorrhage from the tumor. Postoperatively, hormonal therapy was started based on immuno-histopathological findings. DCIS in PT is not encountered frequently and hence no standard management protocol exists for such cases, but when detected by histopathology, the clinical management and prognosis have to undergo a complete change. Preoperative diagnosis and proper individualized management by a multidisciplinary team that ensures clear surgical margins and planned adjuvant therapy play a crucial role in preventing the recurrence of DCIS within PT.
叶状肿瘤（PT）是一种罕见的乳腺良性肿瘤，有复发和转移的倾向。PT内的导管原位癌（DCIS）极为罕见，通常在术后诊断。我们报告一例36岁女性，其左乳复发性肿块被诊断为良性PT。术前，穿刺细胞学检查在已知的复发性PT病例中发现了DCIS。由于肿瘤突然出血无法控制，遂行急诊左侧改良根治性乳房切除术。术后，根据免疫组织病理学结果开始激素治疗。PT中的DCIS并不常见，因此尚无针对此类病例的标准管理方案，但当通过组织病理学检测到时，临床管理和预后必须彻底改变。术前诊断以及由多学科团队进行适当的个体化管理，确保手术切缘清晰并规划辅助治疗，对于预防PT内DCIS的复发起着至关重要作用。
