High grade osteosarcoma originated in a malignant phyllodes turmor

Authors

  • Patricia Lopez Patología Oncológica, Departamento de Patología, Instituto Nacional de Cancerología, Bogotá D. C., Colombia
  • Juan Vergel Clínica de Seno y Tejidos Blandos, Instituto Nacional de Cancerología, Bogotá D. C., Colombia
  • Luis Guzmán Clínica de Seno y Tejidos Blandos, Instituto Nacional de Cancerología, Bogotá D. C., Colombia
  • Carlos Lehman Clínica de Seno y Tejidos Blandos, Instituto Nacional de Cancerología, Bogotá D. C., Colombia

DOI:

https://doi.org/10.35509/01239015.116

Keywords:

Phyllodes tumor, osteosarcoma, surgery, chemotherapy

Abstract

Malignant phyllodes tumor with osteosarcomatous differentiation has a very low incidence. The assessment of this tumor has become a challenge for current medicine due to its difficult histopathological, imaging and clinical diagnosis.

The main treatment is based on surgical management, and the options of adjuvant therapy have not yet presented a solid evidence for its use as standard of care. Its prognosis is not good. The osteoblastic subtype, especially, has a very aggressive behavior, with a risk of 38 % for metastatic compromise and risk of death due to pathology of 33 %.

We present the case of a patient and describe how the disease was diagnosed and treated.

References

Müller J. Uber den feineran Bau and die Forman der krankhaften Geschwilste. Berlin, Germany: G Reimer; 1838.

Tavassoli FA, Devilee P. World Health Organization classifcation of tumors: tumors of the breast and female genital organs. IARC Press, 2003:99-103.

Pietruszka M, Barnes L. Cystosarcoma phyllodes: a clinicopathologic analysis of 42 cases. Cancer. 1978; 41(5):1974-83. https://doi.org/10.1002/1097-0142(197805)41:5<1974::AIDCNCR2820410543>3.0.CO;2-C

Chaney AW, Pollack A, McNeese MD, Zagars GK, Pisters PW, Pollock RE, et al. Primary treatment of cystosarcoma phyllodes of the breast. Cancer. 2000; 89(7):1502-11. https://doi.org/10.1002/1097-0142(20001001)89:7<1502::AID-CNCR13>3.0.CO;2-P

Yilmaz E, Sal S, Lebe B. Differentiation of phyllodes tumors versus fbroadenomas. Acta Radiol. 2002; 43(1):34-9. https://doi.org/10.1080/028418502127347619

Tsubochi H, Sato N, Kaimori M, Imai T. Osteosarcomatous differentiation in lung metastases from a malignant phyllodes tumour of the breast. J Clin Pathol. 2004;57:432-4. https://doi.org/10.1136/jcp.2003.012336

Nieto-Coronel T, Salazar-Campos JE, León D, Díaz-Molina R, Vázquez-Romo R, Bargalló-Rocha E. Tumor phyllodes con transformación a osteosarcoma. Rev. méd. Chile. 2017;145(8):1076-82. https://doi.org/10.4067/s0034-98872017000801076

Liberman L, Bonaccio E, Hamele-Bena D, Abramson AF, Cohen MA, Dershaw DD. Benign and malignant phyllodes tumors: mammographic and sonographic fndings. Radiology 1996;198(1):121-4. https://doi.org/10.1148/radiology.198.1.8539362

Chao TC, Lo YF, Chen SC, Chen MF. Sonographic features of phyllodes tumors of the breast. Ultrasound Obstet Gynecol. 2002;20(1):64-71. https://doi.org/10.1046/j.1469-0705.2002.00736.x

Wurdinger S, Herzog AB, Fischer DR, Marx C, Raabe G, Schneider A, et al. Differentiation of phyllodes breast tumors from fbroadenomas on MRI. AJR Am J Roentgenol. 2005;185(5):1317-21. https://doi.org/10.2214/AJR.04.1620

Yabuuchi H, Soeda H, Matsuo Y, Okafuji T, Eguchi T, Sakai S, et al. Phyllodes tumor of the breast: correlation between MR fndings and histologic grade. Radiology. 2006;241(3):702-9. https://doi.org/10.1148/radiol.2413051470

Harris JR, Lippman ME, Morrow M, Kent Osborne C. Diseases of the breast: Fifth edition. Wolters Kluwer Health Adis, 2014. 1224p.

Lakhani SR, Ellis IO, Schnitt, SJ, Tan, PH, van de Vijver, MJ. WHO Classifcation of Tumours, Volume 4. 2012.

Huang CC, Liu TP, Cheng SP, Chang YC. Surgical treatment of phyllodes tumor of the breast with the trend. Journal of Experimental & Clinical Medicine. 2014;6(5):161-5. https://doi.org/10.1016/j.jecm.2014.08.002

Zhang Y, Kleer CG. Phyllodes tumor of the breast: histopathologic features, differential diagnosis, and molecular/genetic updates. Arch Pathol Lab Med. 2016;140(7):665-71. https://doi.org/10.5858/arpa.2016-0042-RA

Tan WJ, Thike AA, Bay BH, Tan PH. Immunohistochemical expression of homeoproteins Six1 and Pax3 in breast phyllodes tumours correlates with histological grade and clinical outcome. Histopathology. 2014;64(6):807-17. https://doi.org/10.1111/his.12329

Jones AM, Mitter R, Poulsom R, Gillet C, Hanby AM, Tomlinson IP, et al. mRNA expression profling of phyllodes tumours of the breast: identifcation of genes important in the development of borderline and malignant phyllodes tumours. J Pathol. 2008;216(4):408-17. https://doi.org/10.1002/path.2439

Lae M, Vincent-Salomon A, Savignoni A, Huon I, Fréneaux P, Sigal-Zafrani B, et al. Phyllodes tumors of the breast segregate in two groups according to genetic criteria. Mod Pathol. 2007;20(4):435-44. https://doi.org/10.1038/modpathol.3800756

Vidal M, Peg V, Galván P, Tres A, Cortés J, Ramón y Cajal S, et al. Gene expression-based classifcations of fbroadenomas and phyllodes tumours of the breast. Mol Oncol. 2015;9(6):1081-90. https://doi.org/10.1016/j.molonc.2015.01.003

Tan J, Ong CK, Lim WK, Ng CC, Thike AA, Ng LM, et al. Genomic landscapes of breast fbroepithelial tumors. Nat Genet. 2015;47(11):1341-5. https://doi.org/10.1038/ng.3409

Chen WH, Cheng SP, Tzen CY, Yang TL, Jeng KS, Liu CL, et al. Surgical treatment of phyllodes tumors of the breast: retrospective review of 172 cases. J Surg Oncol. 2005;91(3):185-94. https://doi.org/10.1002/jso.20334

Guerrero MA, Ballard BR, Grau AM. Malignant phyllodes tumor of the breast: review of the literature and case report of stromal overgrowth. Surg Oncol. 2003;12(1):27-37. https://doi.org/10.1016/S0960-7404(03)00005-7

Mituś J, Reinfuss M, Mituś JW, Jakubowicz J, Blecharz P, Wysocki WM, et al. Malignant phyllodes tumor of the breast: treatment and prognosis. Breast J. 2014;20(6):639-44. https://doi.org/10.1111/tbj.12333

Spitaleri G, Toesca A, Botteri E, Bottiglieri L, Rotmensz N, Boselli S, et al. Breast phyllodes tumor: a review of literature and a single center retrospective series analysis. Crit Rev Oncol Hematol. 2013;88(2):427-36. https://doi.org/10.1016/j.critrevonc.2013.06.005

August DA, Kearney T. Cystosarcoma phyllodes: mastectomy, lumpectomy, or lumpectomy plus irradiation. Surg Oncol. 2000;9(2):49-52. https://doi.org/10.1016/S0960-7404(00)00022-0

Abdalla HM, Sakr MA. Predictive factors of local recurrence and survival following primary surgical treatment

of phyllodes tumors of the breast. J Egypt Natl Canc Inst. 2006;18(2):125-33.

Kapiris I, Nasiri N, A’Hern R, Healy V, Gui GP. Outcome and predictive factors of local recurrence and distant metastases following primary surgical treatment of high-grade malignant phyllodes tumours of the breast. Eur J Surg Oncol. 2001;27(8):723-30. https://doi.org/10.1053/ejso.2001.1207

Gnerlich JL, Williams RT, Yao K, Jaskowiak N, Kulkarni SA. Utilization of radiotherapy for malignant phyllodes tumors: analysis of the National Cancer Data Base, 1998-2009. Ann Surg Oncol. 2014;21(4):1222-30. https://doi.org/10.1245/s10434-013-3395-6

Sapino A, Bosco M, Cassoni P, Castellano I, Arisio R, Cserni G, et al. Estrogen receptor-beta is expressed in stromal cells of fbroadenoma and phyllodes tumors of the breast. Mod Pathol. 2006;19(4):599-606. https://doi.org/10.1038/modpathol.3800574

Wang H, Wang X, Wang CF. Comparison of clinical characteristics between benign borderline and malignant phyllodes tumors of the breast. Asian Pac J Cancer Prev. 2014;15(24):10791-5. https://doi.org/10.7314/APJCP.2014.15.24.10791

Lightner AL, Shurell E, Dawson N, Omidvar Y, Foster N. A single-center experience and review of the literature: 64 cases of phyllodes tumors to better understand risk factors and disease management. Am Surg. 2015;81(3):309-15.

Rodríguez-Rojas A, Gutiérrez R. Revista Colombiana de Cirugía. 1994;9(3):157-62.

Silver SA, Tavassoli FA. Osteosarcomatous differentiation in phyllodes tumors. Am. J Surg Pathol 1999;23:815-21. https://doi.org/10.1097/00000478-199907000-00010

How to Cite

[1]
López , P. et al. 2022. High grade osteosarcoma originated in a malignant phyllodes turmor. Revista Colombiana de Cancerología. 23, 4 (Aug. 2022), 152–157. DOI:https://doi.org/10.35509/01239015.116.

Downloads

Download data is not yet available.

Published

2019-12-06 — Updated on 2022-08-22

Versions

Issue

Section

Reportes de caso
Crossref Cited-by logo