Skin Recurrence of a Phyllodes Tumor and Impact of Radiotherapy: A Case Report and Review of the Literature

Authors

  • Serap Yücel Department of Radiation Oncology, Bezmialem Vakif University, Medical Faculty, Turkey
  • Hüseyin Kadioglu Department of General Surgery, Bezmialem Vakif University, Medical Faculty, Turkey
  • Zeynep Güral Department of Radiation Oncology, Bezmialem Vakif University, Medical Faculty, Turkey
  • Seyma Yildiz Department of Radiology, Bezmialem Vakif University, Medical Faculty, Turkey
  • Zuhal Gücin Department of Pathology, Bezmialem Vakif University, Medical Faculty, Turkey

DOI:

https://doi.org/10.6000/1929-2279.2013.02.02.7

Keywords:

Phyllodes tumor, Radiotherapy.

Abstract

 Introduction:Phyllodes tumors (PTs) are rare and are usually associated with local recurrences. Determining appropriate clear margins at surgery, adjuvant chemotherapy, and adjuvant radiotherapy is an ongoing dilemma for oncology professionals. The skin recurrence of a PT is not a commonly described situation in the published literature. Herein, we presented a patient with a skin recurrence of a PT. Case:A 48 year old Turkish woman presented with a lump on her left nipple-areolar complex. She had an anamnesis of a lumpectomy for PT 6 years ago and a nipple-areolar complex sparing mastectomy with immediate silicon reconstruction due to the recurrence of PT 3 years ago. No adjuvant treatment was administered after either of these surgical procedures. A magnetic resonance examination of her breast and a histopathological evaluation revealed the skin recurrence of PT. A nipple-areolar complex excision with 2 cm clear margins and adjuvant radiotherapy was then administered to her as the treatment regimen. Discussion:Surgery is defined as the effective treatment for PT but patients with high risk factors as large tumor size, positive margins and recurrent disease adjuvant treatments must be added.

References

Fiks A. Cystosarcoma phyllodes of the mammary gland—Müller’s tumor. For the 180th birthday of Johannes Müller. Virchows Arch A Pathol Anat Histol 1981; 392: 1-6. http://dx.doi.org/10.1007/BF00430543

Buchanan EB. Cystosarcoma phyllodes and its surgical management. Am Surg 1995; 61: 350-55.

Parker SJ, Harries SA. Phyllodes tumours. Postgrad Med J 2001; 77: 428-35. http://dx.doi.org/10.1136/pmj.77.909.428

Tavassoli FA DP. Pathology and genetics of tumours of the breast and female genital organs. In: World Health Organization Classification of Tumours. Lyon: IARC Press 2003; pp. 99-103.

Müller J. Uber den feineran Bau und die Forman der krankhaften Geschwilste. G Reimer 1838.

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

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

Haberer S, Lae M, Seegers V, et al. Management of malignant phyllodes tumors of the breast: The experience of the Institut Curie. Cancer Radiother 2009; 13: 305-12. http://dx.doi.org/10.1016/j.canrad.2009.05.001

Asoglu O, Ugurlu MM, Blanchard K, et al. Risk factors for recurrence and death after primary surgical treatment of malignant phyllodes tumors. Ann Surg Oncol 2004; 11: 1011-17. http://dx.doi.org/10.1245/ASO.2004.02.001

Chen WH, Cheng SP, Tzen CY, et al. Surgical treatment of phyllodes tumors of the breast: Retrospective review of 172 cases. J Surg Oncol 2005; 91: 185-94. http://dx.doi.org/10.1002/jso.20334

Sabban F, Collinet P, Lucot JP, et al. Phyllodes tumor of the breast: Analysis of 8 patients. J Gynecol Obstet Biol Reprod (Paris) 2005; 34(3 Pt 1): 252-56. http://dx.doi.org/10.1016/S0368-2315(05)82743-7

Ben Hassouna J, Damak T, Gamoudi A, et al. Phyllodes tumors of the breast: A case series of 106 patients. Am J Surg 2006; 192: 141-47. http://dx.doi.org/10.1016/j.amjsurg.2006.04.007

Macdonald OK, Lee CM, Tward JD, et al. Malignant phyllodes tumor of the female breast: Association of primary therapy with cause-specific survival from the Surveillance, Epidemiology, and End Results (SEER) program. Cancer 2006; 107: 2127-33. http://dx.doi.org/10.1002/cncr.22228

Fou A, Schnabel FR, Hamele-Bena D, et al. Long-term outcomes of malignant phyllodes tumor patients: An institutional experience. Am J Surg 2006; 192: 492-95. http://dx.doi.org/10.1016/j.amjsurg.2006.06.017

Taira N, Takabatake D, Aogi K, et al. Phyllodes tumor of the breast: Stromal overgrowth and histological classification are useful prognosis-predictive factors for local recurrence in patients with a positive surgical margin. Jpn J Clin Oncol 2007; 37: 730-36. http://dx.doi.org/10.1093/jjco/hym099

Lenhard MS, Kahlert S, Himsl I, et al. Phyllodes tumour of the breast: Clinical follow-up of 33 cases of this rare disease. Eur J Obstet Gynecol Reprod Biol 2008; 138: 217-21. http://dx.doi.org/10.1016/j.ejogrb.2007.08.002

Belkacemi Y, Bousquet G, Marsiglia H, et al. Phyllodes tumor of the breast. Int J Radiat Oncol Biol Phys 2008; 70: 492-500. http://dx.doi.org/10.1016/j.ijrobp.2007.06.059

Pezner RD, Schultheiss TE, Paz IB. Malignant phyllodes tumor of the breast: Local control rates with surgery alone. Int J Radiat Oncol Biol Phys 2008; 71: 710-13. http://dx.doi.org/10.1016/j.ijrobp.2007.10.051

Bouhafa T, Masbah O, Bekkouch I, et al. Phyllodes tumors of the breast: Analysis of 53 patients. Cancer Radiother 2009; 85-91. http://dx.doi.org/10.1016/j.canrad.2008.11.007

Confavreux C, Lurkin A, Mitton N, et al. Sarcomas and malignant phyllodes tumours of the breast-a retrospective study. Eur J Cancer 2006; 42: 2715. http://dx.doi.org/10.1016/j.ejca.2006.05.040

Reinfuss M, Mitus J, Duda K, et al. The treatment and prognosis of patients with phyllodes tumor of the breast: An analysis of 170 cases. Cancer 1996; 77: 910-16. http://dx.doi.org/10.1002/(SICI)1097-0142(19960301)77:5<910::AID-CNCR16>3.0.CO;2-6

Kapiris I, Nasiri N, A’Hern R, et al. 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: 723-30. http://dx.doi.org/10.1053/ejso.2001.1207

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: 125-33.

Barrio AV, Clark BD, Goldberg JI, et al. Clinicopathologic features and long-term outcomes of 293 phyllodes tumors of the breast. Ann Surg Oncol 2007; 14: 2961-70. http://dx.doi.org/10.1245/s10434-007-9439-z

Belkace´mi Y, Zouhair A, Ozsahin M, et al. -O pour le re´seau des cancers rares (Rare Cancer Network). Facteurs pronostiques et prise en charge des tumeurs rares. Cancer ⁄ Radiothe´rapie 2006; 10: 323-29.

Shabahang M, Franceschi D, Sundaram M, et al. Surgical management of primary breast sarcoma. Am Surg 2002; 68: 673-77, discussion 77.

Cohn-Cedermark G, Rutqvist LE, Rosendahl I, et al. Prognostic factors in cystosarcoma phyllodes. A clinicopathologic study of 77 patients. Cancer 1991; 68: 2017-22. http://dx.doi.org/10.1002/1097-0142(19911101)68:9<2017::AID-CNCR2820680929>3.0.CO;2-V

Jang JH, Choi MY and Lee SK. Clinicopathologic risk factors for the local recurrence of phyllodes tumors of the breast. Ann Surg Oncol 2012; 19(8): 2612-17.

Tan PH, Thike AA, Tan WJ, et al. Predicting clinical behaviour of breast phyllodes tumours: A nomogram based on histological criteria and surgical margins. J Clin Pathol 2012; 65(1): 69-76. http://dx.doi.org/10.1136/jclinpath-2011-200368

National Comprehensive Cancer Network (NCCN) guidelines. Available at: www.nccn.org (Accessed on March 15, 2013).

Soumarova R, Seneklova Z, Horova H, et al. Retrospective analysis of 25 women with malignant cystosarcoma phyllodes—treatment results. Arch Gynecol Obstet 2004; 269: 278-81. http://dx.doi.org/10.1007/s00404-003-0593-7

Geppert M, Bachmann FF. Rare presentations of cytosarcoma phylloides. Geburtshilfe Frauenheilkd 1982; 42: 732-35. http://dx.doi.org/10.1055/s-2008-1037152

Eich PD, Diederich S, Eich HT, et al. Diagnostic radiation oncology: Malignant cystosarcoma phyllodes. Strahlenther Onkol 2000; 176: 192-95. http://dx.doi.org/10.1007/s000660050056

Belkacemi Y, Bousquet G, Marsiglia H, et al. Phyllodes tumor of the breast. Int J Radiat Oncol Biol Phys 2008; 70: 492-500. http://dx.doi.org/10.1016/j.ijrobp.2007.06.059

Burton GV, Hart LL, Leight GS Jr, et al. Cystosarcoma phyllodes. Effective therapy with cisplatin and etoposide chemotherapy. Cancer 1989; 63: 2088. http://dx.doi.org/10.1002/1097-0142(19890601)63:11<2088::AID-CNCR2820631103>3.0.CO;2-C

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Published

2013-07-10

How to Cite

Serap Yücel, Hüseyin Kadioglu, Zeynep Güral, Seyma Yildiz, & Zuhal Gücin. (2013). Skin Recurrence of a Phyllodes Tumor and Impact of Radiotherapy: A Case Report and Review of the Literature . Journal of Cancer Research Updates, 2(2),  131–134. https://doi.org/10.6000/1929-2279.2013.02.02.7

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