Hara Yuki, Yamaguchi Rin, Otsubo Ryota, Fukushima Ayako, Inamasu Eiko, Akashi Momoko, Morita Michi, Kuba Sayaka, Eguchi Susumu, Matsumoto Keitaro
Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
Department of Breast Center, Nagasaki University Hospital, Nagasaki, Japan.
J Breast Cancer. 2024 Oct;27(5):343-349. doi: 10.4048/jbc.2024.0159.
Phyllodes tumors (PT) are fibroepithelial neoplasms that are treated by complete surgical excision. The effectiveness of adjuvant therapies, including radiotherapy and chemotherapy, for PT remains unclear, and the use of neoadjuvant chemotherapy (NAC) is yet to be established. We report a case of a 15-year-old girl with acute lymphatic leukemia (ALL) who was incidentally diagnosed with a 50-mm borderline PT in the left breast using computed tomography, ultrasonography, and histological examination following needle biopsy. Lumpectomy was performed after administration of anthracycline-based chemotherapy for ALL, resulting in tumor size reduction. Histopathological examination of the excised specimen demonstrated decreased mitotic activity and stromal cellularity post-chemotherapy. To our knowledge, this is the first study to report the histopathological differences in pre- and post-chemotherapy borderline PT samples. Our findings suggest that NAC may induce changes in borderline PT, potentially affecting diagnosis and treatment decisions. Hence, further investigation is warranted in this regard.
叶状肿瘤（PT）是一种纤维上皮性肿瘤，通过完整的手术切除进行治疗。包括放疗和化疗在内的辅助治疗对PT的有效性仍不明确，新辅助化疗（NAC）的应用也尚未确立。我们报告了一例15岁急性淋巴细胞白血病（ALL）女孩的病例，该女孩在接受ALL的蒽环类化疗后，通过计算机断层扫描、超声检查以及针吸活检后的组织学检查，偶然发现左乳有一个50毫米的交界性PT。乳房肿块切除术在ALL的蒽环类化疗后进行，肿瘤大小缩小。对切除标本的组织病理学检查显示化疗后有丝分裂活性和间质细胞密度降低。据我们所知，这是第一项报告化疗前后交界性PT样本组织病理学差异的研究。我们的研究结果表明，NAC可能会引起交界性PT的变化，潜在地影响诊断和治疗决策。因此，在这方面有必要进行进一步研究。
