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切缘宽度仍然具有相关性:一例再切除切缘中存在卫星结节的边界清楚的交界性叶状肿瘤病例

Wide Margins are Still Relevant: A Case of a Well-Circumscribed Borderline Phyllodes Tumor With a Satellite Nodule in a Re-excision Margin.

作者信息

Reason Ellery H, Sotolongo Gina, Bentley Rex C, Factor Rachel E, Jeck William R, Rosenberger Laura H

机构信息

Department of Surgery, Duke University School of Medicine, Durham, USA.

Department of Pathology, Duke University Health System, Durham, USA.

出版信息

Cureus. 2025 Mar 1;17(3):e79890. doi: 10.7759/cureus.79890. eCollection 2025 Mar.

Abstract

Phyllodes tumors (PTs) of the breast are rare fibroepithelial neoplasms with high rates of local recurrence (LR) for which surgical excision remains the mainstay of treatment. The recommended surgical margin width is debated and varies based on the histologic grade. We present a case of a middle-aged woman with a well-circumscribed borderline PT who underwent margin re-excision, with a distinct focus of the PT detected at a previously negative margin. Given the high rates of LR and potential for histologic upgrade at the time of recurrence, combined with the current limited understanding of peritumoral tissue and possible satellite foci, a wide negative margin remains the recommendation for borderline PTs.

摘要

乳腺叶状肿瘤(PTs)是罕见的纤维上皮性肿瘤,局部复发(LR)率高,手术切除仍是主要治疗方法。推荐的手术切缘宽度存在争议,且因组织学分级而异。我们报告一例中年女性,患有边界清晰的交界性PT,接受了切缘再次切除,在先前阴性的切缘处发现了PT的一个明显病灶。鉴于LR率高以及复发时组织学升级的可能性,再加上目前对肿瘤周围组织和可能的卫星灶了解有限,对于交界性PTs,仍建议切缘阴性且范围要宽。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/428b/11957470/932987c472cc/cureus-0017-00000079890-i01.jpg

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