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乳腺恶性叶状肿瘤伴肺转移:一例报告及文献复习

Malignant phyllodes tumor of the breast with metastases to the lungs: A case report and literature review.

作者信息

Ostapenko Edvin, Burneckis Arvydas, Ostapenko Andrej, Skaisgirytė Audronė, Ostapenko Valerijus

机构信息

National Cancer Institute, Santariskiu str. 1, Vilnius LT-08660, Lithuania.

Faculty of Medicine, Vilnius University, Vilnius, Lithuania.

出版信息

Radiol Case Rep. 2022 Aug 18;17(10):4006-4012. doi: 10.1016/j.radcr.2022.07.037. eCollection 2022 Oct.

Abstract

Phyllodes tumors (PTs) are rare fibroepithelial neoplasms of the breasts. Approximately 10%-15% of PTs are malignant, and 9%-27% of patients with malignant PTs, develop metastatic disease. The lungs are the most common target organ for distant metastasis of PT. We report a case of 44-year-old female with a malignant PT. It had recurred locally 3 times, and 3 relapses occurred 13 months after the first diagnosis, presenting multiple metastases to the lungs by CT scan. The patient underwent radiation therapy, and palliative chemotherapy with doxorubicin was initiated. Two courses of doxorubicin therapy were administered, but the patient expired 16 months after PT diagnosis. We present a rare case of malignant PT with local recurrences, lung metastases, and poor patient outcome. Although malignant breast PTs have an unfavorable prognosis, adjuvant radiotherapy combined with margin-negative resection may be associated with decreased local recurrence and distant metastasis rates. Future research should include randomized clinical trials or well-designed prospective matched studies to clarify the effectiveness of treatments of PTs.

摘要

叶状肿瘤(PTs)是一种罕见的乳腺纤维上皮性肿瘤。约10%-15%的叶状肿瘤为恶性,9%-27%的恶性叶状肿瘤患者会发生转移性疾病。肺是叶状肿瘤远处转移最常见的靶器官。我们报告一例44岁女性的恶性叶状肿瘤病例。该肿瘤已局部复发3次,首次诊断后13个月出现3次复发,CT扫描显示肺部有多处转移。患者接受了放射治疗,并开始使用阿霉素进行姑息化疗。给予了两个疗程的阿霉素治疗,但患者在叶状肿瘤诊断后16个月死亡。我们呈现了一例罕见的恶性叶状肿瘤病例,伴有局部复发、肺转移且患者预后较差。尽管恶性乳腺叶状肿瘤预后不良,但辅助放疗联合切缘阴性切除术可能会降低局部复发率和远处转移率。未来的研究应包括随机临床试验或精心设计的前瞻性匹配研究,以阐明叶状肿瘤治疗的有效性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/31de/9418210/16f1794cd5e2/gr1.jpg

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