Jayaraman MonishaRita, V Lakshmipriya, Diwagar Nithin, Esakki Muthuvel
Pathology, Saveetha Medical College and Hospital, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND.
Cureus. 2024 Jun 10;16(6):e62114. doi: 10.7759/cureus.62114. eCollection 2024 Jun.
Phyllodes tumors (PTs) are uncommon breast tumors. They represent a spectrum of benign to malignant neoplasms. These erratic tumors have traits ranging from fibroadenomas on one end of the spectrum to sarcomas on the other end. The presentation of PT is variable, thus posing a diagnostic difficulty. Malignant PTs are often associated with recurrence, poor prognosis, and adverse disease outcomes. The recent genetic studies produced by genome sequencing offer information about the molecular pathophysiology of PT, aid in enhancing diagnostic precision, and suggest possible therapeutic targets in cases of malignant PT. Planning a treatment modality and prognostication requires meticulous histopathological sampling, as it relies on a correct histopathological diagnosis. There are no definitive guidelines for surgical management and targeted therapy for malignant PTs due to the rarity of these cases and very little available literature on these topics. Here in this article, we address a malignant PT in a 74-year-old female that presented as a breast mass mimicking metaplastic breast carcinoma histologically. This article also illuminates how immunohistochemistry plays a vital role in the diagnosis of this tumor.
叶状肿瘤（PTs）是一种罕见的乳腺肿瘤。它们代表了一系列从良性到恶性的肿瘤。这些多变的肿瘤具有从纤维腺瘤（位于谱系一端）到肉瘤（位于谱系另一端）的各种特征。PT的表现各不相同，因此造成了诊断困难。恶性PT常与复发、预后不良及不良疾病结局相关。近期通过基因组测序进行的遗传学研究提供了有关PT分子病理生理学的信息，有助于提高诊断准确性，并为恶性PT病例提示可能的治疗靶点。规划治疗方式和进行预后评估需要细致的组织病理学取样，因为这依赖于正确的组织病理学诊断。由于这些病例罕见且关于这些主题的可用文献极少，目前尚无针对恶性PT手术管理和靶向治疗的确切指南。在本文中，我们探讨了一名74岁女性的恶性PT，该肿瘤在组织学上表现为类似化生性乳腺癌的乳腺肿块。本文还阐明了免疫组化在该肿瘤诊断中如何发挥至关重要的作用。
