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乳腺恶性叶状肿瘤伴双侧导管原位癌及术后远处转移:1例病例报告

Malignant phyllodes tumor of the breast with bilateral ductal carcinoma in situ and postoperative distant metastasis: a case report.

作者信息

Liu Hongyu, Wang Bin, Chen Yuxingzi

机构信息

Department of Radiology, Taizhou Central Hospital (Taizhou University Hospital), Taizhou, China.

Department of Nuclear Medicine, Taizhou Central Hospital (Taizhou University Hospital), Taizhou, China.

出版信息

Transl Cancer Res. 2024 Nov 30;13(11):6576-6583. doi: 10.21037/tcr-24-497. Epub 2024 Nov 21.

DOI:10.21037/tcr-24-497
PMID:39697724
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11651784/
Abstract

BACKGROUND

Phyllodes tumors (PTs) are breast neoplasms with varying degrees of malignancy, posing challenges in diagnosis and management. This case report focuses on a rare case of malignant phyllodes tumor of the breast (MPTB) in a 35-year-old woman.

CASE DESCRIPTION

This case report presents a complex scenario of a patient with extensive breast abnormalities, including a malignant PT in the left breast, ductal carcinoma in both breasts, with axillary lymph node involvement. Radiological examinations revealed multiple masses with varying characteristics, leading to a challenging diagnosis. Considering a huge malignant breast tumor, surgery was suggested immediately without biopsy. Surgical intervention, including modified radical mastectomy, was performed, and pathological findings diagnosed of malignant PT with intraductal carcinoma. The patient experienced disease progression shortly after surgery, with metastases detected in the left axillary lymph node and both lungs at the third month after discharge. Despite further treatment is suggested, the patient refused the treatment options. The patient's condition rapidly deteriorated, leading to her unfortunate demise four months after surgery.

CONCLUSIONS

This case accentuates the complex nature of MPTB, highlighting the urgent need for seeking medical attention promptly, sufficient preoperative assessment, improved diagnostic techniques, interdisciplinary collaboration, and advanced treatment.

摘要

背景

叶状肿瘤(PTs)是具有不同程度恶性的乳腺肿瘤,在诊断和管理方面存在挑战。本病例报告聚焦于一名35岁女性罕见的乳腺恶性叶状肿瘤(MPTB)病例。

病例描述

本病例报告呈现了一名患者复杂的病情,其乳腺存在广泛异常,包括左侧乳腺的恶性PT、双侧导管癌以及腋窝淋巴结受累。影像学检查显示多个具有不同特征的肿块,导致诊断具有挑战性。鉴于巨大的乳腺恶性肿瘤,建议立即手术而不进行活检。进行了包括改良根治性乳房切除术在内的手术干预,病理结果诊断为恶性PT伴导管内癌。患者术后不久病情进展,出院后第三个月在左侧腋窝淋巴结和双肺检测到转移。尽管建议进一步治疗,但患者拒绝了治疗方案。患者病情迅速恶化,术后四个月不幸死亡。

结论

本病例突出了MPTB的复杂性,强调了及时就医、充分的术前评估、改进的诊断技术、多学科协作和先进治疗的迫切需求。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fa2f/11651784/84fd94b7f550/tcr-13-11-6576-f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fa2f/11651784/f3a5f8504039/tcr-13-11-6576-f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fa2f/11651784/84fd94b7f550/tcr-13-11-6576-f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fa2f/11651784/f3a5f8504039/tcr-13-11-6576-f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fa2f/11651784/84fd94b7f550/tcr-13-11-6576-f2.jpg

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本文引用的文献

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Malignant phyllodes tumor of the breast with heterologous osteosarcoma and chondrosarcomatous differentiation: A rare case report with imaging findings.伴有异源性骨肉瘤和软骨肉瘤分化的乳腺恶性叶状肿瘤:一例罕见病例报告及影像学表现
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Transformation of a Benign-Appearing Fibroepithelial Lesion to a Giant Malignant Phyllodes Tumor of the Breast.良性外观的纤维上皮性病变转变为乳腺巨大恶性叶状肿瘤
Cureus. 2022 Dec 23;14(12):e32881. doi: 10.7759/cureus.32881. eCollection 2022 Dec.
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Lymph Node and Distant Metastases in Phyllodes Tumor of the Breast.
乳腺叶状肿瘤的淋巴结和远处转移。
Int J Surg Pathol. 2023 Aug;31(5):761-764. doi: 10.1177/10668969221125791. Epub 2022 Oct 25.
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Radiol Case Rep. 2022 Aug 18;17(10):4006-4012. doi: 10.1016/j.radcr.2022.07.037. eCollection 2022 Oct.
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Malignant phyllodes tumor of the breast: a systematic review.乳腺恶性叶状肿瘤:系统评价。
Pathologica. 2022 Apr;114(2):111-120. doi: 10.32074/1591-951X-754. Epub 2022 Apr 13.
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Malignant Phyllodes Tumor of the Breast: A Practice Review.乳腺恶性叶状肿瘤:实践综述
Clin Pract. 2021 Apr 6;11(2):205-215. doi: 10.3390/clinpract11020030.
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Phyllodes Tumors of the Breast: A Literature Review.乳腺叶状肿瘤:文献综述
Cureus. 2020 Sep 7;12(9):e10288. doi: 10.7759/cureus.10288.
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