Shinzaki Wataru, Terashita Daisuke, Kanaizumi Hirofumi, Wakasa Tomoko, Kimura Yutaka, Komoike Yoshifumi
Department of Breast and Endocrine Surgery, Kindai University Nara Hospital, 1248-1, Otoda-cho, Ikoma, Nara 630-0293, Japan.
Department of Breast and Endocrine Surgery, Kindai University Nara Hospital, 1248-1, Otoda-cho, Ikoma, Nara 630-0293, Japan.
Int J Surg Case Rep. 2024 Sep;122:110162. doi: 10.1016/j.ijscr.2024.110162. Epub 2024 Aug 13.
Phyllodes tumors (PTs) are rare breast neoplasms, with an incidence rate of <1 %. Further, the coexistence of PTs and carcinoma is also uncommon. In this report, we describe a rare case of the synchronous coexistence of a benign PT and invasive ductal carcinoma (IDC) of the ipsilateral breast.
A 42-year-old woman presented with a 6-month history of a tumor in her right breast. Mammography and ultrasonography revealed a 9.0 cm breast lump, and core biopsy revealed a benign PT. A simple mastectomy of the right breast revealed IDC foci in the mammary area, close to the benign PT. Right axillary lymph node staging was performed by surgery. However, no lymph node metastasis was observed. Subsequently, appropriate adjuvant therapy was initiated. Currently, the patient is doing well.
Breast cancer may be located close to the PT of the ipsilateral breast and is difficult to detect preoperatively, especially in cases of large PTs. Early detection of the presence of a coexisting carcinoma is clinically important because it can alter patient management.
Careful assessment of the PT using additional breast imaging tools might help identify their coexistence with breast cancer in cases of difficult diagnosis of coexistent tumors using standard breast imaging tools such as mammography or ultrasound.
叶状肿瘤(PTs)是罕见的乳腺肿瘤,发病率低于1%。此外,PTs与癌并存的情况也不常见。在本报告中,我们描述了一例同侧乳腺良性PT与浸润性导管癌(IDC)同步并存的罕见病例。
一名42岁女性,右乳肿物6个月。乳腺钼靶和超声检查发现一个9.0厘米的乳腺肿块,粗针活检显示为良性PT。右乳单纯乳房切除术显示在乳腺区域靠近良性PT处有IDC病灶。通过手术进行右腋窝淋巴结分期。然而,未观察到淋巴结转移。随后,开始进行适当的辅助治疗。目前,患者情况良好。
乳腺癌可能位于同侧乳腺的PT附近,术前难以检测到,尤其是在PT较大的情况下。早期发现并存癌在临床上很重要,因为它会改变患者的治疗方案。
在使用乳腺钼靶或超声等标准乳腺成像工具难以诊断并存肿瘤的情况下,使用额外的乳腺成像工具仔细评估PT可能有助于识别其与乳腺癌的并存情况。