A rare biphasic tumour of the breast characterised by a proliferation of sarcomatous spindle cells surrounding rounded tubules and infiltrating the surrounding adipose tissue. <> Introduction: Periductal Stromal Sarcoma (PSS), especially spindle and epithelioid types, is a rare subtype of the malignant fibroepithelial tumor with benign ductal elements and a sarcomatous stroma composed of spindle cells. Introduction. Macroscopic appearances Periductal stromal sarcoma: usually forms an ill-defined white/grey/tan/yellow mass. It has biphasic morphology with benign ducts and a sarcomatous stroma with no specific clinical or radiologic findings, which makes it difficult to diagnose (1-4).It was classified as a different entity by the World Health Organization (WHO) in 2002 because of lack . Phyllodes tumors (from Greek: phullon), are a rare type of biphasic fibroepithelial mass that form from the periductal stromal and epithelial cells of the breast. The epithelial component was intensely positive in all cases.). Copyright 2014 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved. Periductal stromal sarcoma (PSS) is a type of rare malignant fibroepithelial tumor. Periductal stromal tumor (PDST) is a rare biphasic tumor of the breast that exhibits low-grade malignancy and intermediate behavior. Phyllodes Tumor of the Breast Definition Mixed epithelial and stromal/mesenchymal proliferation of breast characterized by increased stromal cellularity and characteristic broad "leaf-like" papillae inserted into cleft-like spaces Alternate/Historical Names Cystosarcoma phyllodes Diagnostic Criteria Usually large and grossly circumscribed It is a challenge to diagnose the phyllodes by conventional trucut biopsy technique. They have been documented to occur at any age below 12 years. When severe, mastitis can lead to a breast abscess (5%-11%) or septicemia. The cytologic characteristics of the mesenchymal elements are virtually identical to those seen in phyllodes tumors (PT . /97EO, xk1*9m ~#oQ}jPNU0 %r# t&NY[6 8}Ed> P!-tsrYTNLYoC k. Federal government websites often end in .gov or .mil. Periductal mastitis is most common in younger, reproductive-age women. Which Of The Following Are True Of Mockumentaries? { soundManager.url = 'http://www.soundviewelectronics.com/wp-content/plugins/compact-wp-audio-player/swf/soundmanager2.swf'; Some regard tumors with predominant periductal stromal expansion (i.e., periductal stromal tumor) as a distinct subtype of phyllodes tumor Page views in 2022 to date: 72,633. . PMC phyllodes tumors are rare, comprising 2.5% of fibroepithelial lesions and 0.3-1% of all primary breast tumors. Periductal stromal condensation may be seen; Frankly sarcomatous stroma may be seen in malignant phyllodes tumor . The palpable mass in the right breast was confirmed as low-grade periductal stromal tumor and there were bilateral invasive ductal carcinomas in both upper outer breast quadrants. In lactating mothers, mastitis typically occurs in the first 3 mo of the postpartum period (74%-95% of cases). low grade sarcoma, NOS: these generally displace mammary tissue. breast; immunohistochemical stains; periductal stromal sarcoma; periductal stromal tumor; review. Ann Clin Lab Sci. 3, 7 the spindle Periductal stromal hyperplasia (PDSH) has been known to present as densities in the breast or vague nodularities, while periductal stromal sarcoma (PDSS) historically presents as a mass, often mimicking fibroadenomas or hamartoma. if (inputs[i].id.indexOf("btnplay_") == 0) { Which of the following features can be seen in malignant phyllodes tumors but not metaplastic carcinomas? The tumor is circumscribed. Periductal stromal tumor (PDST) is a rare biphasic tumor of the breast that exhibits low-grade malignancy and intermediate behavior. PubMed Search: Phyllodes tumor of the breast[TI] full text[SB] pathology. 'size': divs[ j ].getAttribute( 'data-size' ), . Chen, C.M., Chen, C.J., Chang, C.L., Shyu, J.S., Hsieh, H.F. and Harn, H.J. Phyllodes tumors. CD34, CD117, and actin expression in phyllodes tumor of the breast. The https:// ensures that you are connecting to the mp3url = new Array(mp3file, oggfile); Page views in 2021: 73,206. Periductal stromal tumor (PDST) is a rare biphasic tumor of the breast that exhibits low-grade malignancy and intermediate behavior. Periductal stromal tumor (PST) is an extremely rare, low-grade neoplasm that arises from breast connective tissue. Am J Surg Pathol 2003; 27: 343-8. Spindle cells were positive for CD34, and negative for SMA, myosin, CD117, and beta-catenin. Care should be taken when considering the diagnosis of fibroadenoma based only on clinical, radiological, and biopsy findings. Before It is typically a large, fast growing mass that forms from the periductal stroma of the breast 13. Periductal stromal tumor (PST) of the breast is a rare fibroepithelial neoplasm with controversial pathogenesis. Please enable it to take advantage of the complete set of features! Disclaimer, National Library of Medicine The .gov means its official. This site needs JavaScript to work properly. Phyllodes Tumor of the Breast Definition Mixed epithelial and stromal/mesenchymal proliferation of breast characterized by increased stromal cellularity and characteristic broad "leaf-like" papillae inserted into cleft-like spaces Alternate/Historical Names Cystosarcoma phyllodes Diagnostic Criteria Usually large and grossly circumscribed Lyon: IARC Press, 2012; 145. Periductal stromal tumor (PDST) is a rare biphasic tumor of the breast that exhibits low-grade malignancy and intermediate behavior. 2015 May;23(3):221-4. doi: 10.1177/1066896914567331. Periductal stromal sarcoma in a child: a case report. MeSH } Most recent WHO edition (2012) reclassified as "periductal stromal tumour" as the preferred "neutral term" in the family of fibroepithelial tumor Stromal proliferation around open, benign tubules Essential features Considered a type of fibroepithelial tumor lesion with stromal proliferation around benign tubules An extremely rare entity, the PST is actually classified as a subtype of phyllodes tumor, with specific criteria that are only found upon histological examination of the specimen. Periductal stromal tumor; bilateral breast cancer; breast cancer. Periductal stromal tumor: a rare lesion with low-grade sarcomatous behavior. Disclaimer, National Library of Medicine XyH 5{ZHjh5f(q(Z8Rl"Zp}VqJ~1q\gUt}1gWXE%.1_b0Kd!`L8t %9x!..Tb)n"%&kw#F&C.0iHWW|A^t7sk,k'P)"PzA[*e::YXZV+A~cW(:)%E^{JH?blOeX=K2=[5R:4(40"0]jRm|PpowrnMS@s\(3kS9u3y3E.auxjvqRAjj{ryP=6g=O,*G6d{B~{wZjZ"g%Sx*)\]{ endobj Masbah O, Lalya I, Mellas N, et al. Keywords: Fibroadenomas are common benign neoplasms that may be treated conservatively. recaptchaWidgets.push( widget_id ); Phyllodes tumor of the breast[TI] full text[SB] pathology, WHO Classification of Tumours Editorial Board: Breast Tumours, 5th Edition, 2019, NCCN Guidelines: Breast Cancer - Phyllodes Tumor [Accessed 2 July 2020], eMedicine: Phyllodes Tumor (Cystosarcoma Phyllodes) [Accessed 2 July 2020], Stanford University: Phyllodes Tumor of the Breast [Accessed 2 July 2020], Presence directly upgrades to malignant category**, Biphasic fibroepithelial neoplasm with leaf-like epithelial (phyllodal) pattern and stromal proliferation, Biphasic fibroepithelial lesion characterized by leaf-like phyllodal epithelial pattern, Graded and prognosticated by histologic changes of the stromal proliferation, Epithelial component is benign in phyllodes tumor, Cystosarcoma phyllodes (the use of this term is discouraged), Incidence rate of 2.1 per 1 million women (, Benign phyllodes tumor most common (60 - 75%), followed by borderline (15 - 26%) and malignant (8 - 20%) tumors (, Benign phyllodes tumor occurs at a younger age compared with borderline and malignant phyllodes tumors (, Can occur rarely in pediatric age group and male, Reported to develop in ectopic breast tissue, including vulva (, Biphasic lesion with epithelial stromal interaction involved in tumorigenesis (, Loss of epithelial interaction in stromal component believed to lead to malignant progression (, Areas resembling well differentiated liposarcoma in phyllodes tumor lack, Increased incidence reported in Li-Fraumeni syndrome (, Commonly presents with firm, asymptomatic, mobile breast mass, Large tumor (up to 20 cm) can cause skin ulceration and pain (, Bloody nipple discharge uncommon and attributed to infarction and intraductal involvement (, Rare cases of hypoglycemia due to insulin-like growth factor II production (, Largely dependent on histologic diagnosis, Ultrasound and mammography do not accurately differentiate phyllodes tumor from fibroadenoma (, Ultrasound unreliable in grading of phyllodes tumor (, Prognosis correlates with histologic grade, Very low rate of local recurrence regardless of margin status (, Does not metastasize or cause mortality (, Recurrences may be benign but may also progress to borderline or malignant phylldoes tumors (, Behavior intermediate between benign and malignant phyllodes tumors (, Higher risk of local recurrence than benign phyllodes tumor, Sites include lung, pleura, bone, central nervous system, visceral organs and soft tissue, Presence of malignant heterologous elements, necrosis and tumor size correlated with metastasis (, Axillary nodal involvement by metastatic disease uncommon, Positive margin status associated with local recurrence, Tumor size is an independent risk factor for local recurrence (, 30 year old woman with painless breast mass (, 37 year old woman with multiple metastases including adrenal gland (, 44 year old woman with repeated local recurrence (, 47 year old woman with malignant phyllodes tumor showing liposarcomatous differentiation (, 70 year old woman with benign phyllodes tumor and concomitant ductal carcinoma in situ (, Narrow margins may be adequate for benign phyllodes tumor, Exact extent of clearance under debate, currently no consensus as to adequate margin width, while 10 mm is generally considered acceptable (, Efficacy of radiotherapy unclear, may improve local control but not overall survival in borderline and malignant phyllodes tumor (, Infiltrative in malignant and less commonly borderline phyllodes tumor, Whorled, bosselated cut surface in a leaf-like pattern, Skin ulceration, hemorrhage and cystic changes in large lesions (, Ulceration and hemorrhage do not indicate malignant behavior per se, Infarcted or very large benign phyllodes tumor can also show necrosis, Leaf-like (phyllodal) epithelial pattern formed by an exaggerated intracanalicular pattern, Subepithelial condensation with increased stromal cellularity adjacent to epithelium, Some regard tumors with predominant periductal stromal expansion (i.e., periductal stromal tumor) as a distinct subtype of phyllodes tumor, Graded into benign, borderline and malignant histologic grades, Cystic degeneration, hemorrhage, stromal hyalinization and myxoid change reported, Multinucleated stromal giant cells occasionally seen (, Can be found in phyllodes tumor of all histologic grades, Epithelium can be scarce in malignant phyllodes tumor with extensive stromal overgrowth, Incidental involvement by in situ and invasive carcinomas (, Myoepithelial layer is preserved but can be attenuated, Reduced epithelial stromal ratio compared with fibroadenomas, Higher nuclear atypia and cellularity in phyllodes tumor of higher grades, Large wavy and folded epithelial clusters, Occasionally, hyperplastic changes with enlarged and vesicular nuclei and small visible nucleoli may be seen, Increased atypia in dispersed cells in phyllodes tumor of higher grades (, Multinucleated tumor cells and marked stromal anaplasia reported in malignant phyllodes tumor (, Chromosome abnormalities increase with grade (. Recent developments in the histological diagnosis of spindle cell carcinoma, fibromatosis and phyllodes tumour of the breast. case 'spam': Periductal mastitis is most common in younger, reproductive-age women. The other had lung metastases, presumably from an angiosarcomatous component. Multinucleated stromal giant cells can be seen in . PubMed Search: Phyllodes tumor of the breast[TI] full text[SB] pathology. This is about 15 years older than the typical age of patients with fibroadenoma, a condition with which phyllodes tumors may be confused. Phyllodes tumor, also known as cystosarcoma phyllodes, is a rare fibroepithelial tumor of the breast which has some resemblance to a fibroadenoma. They are classified as a fibroepithelial tumor by ICD-O, but not by MeSH. However, PDSS and PDSH may or may not form masses and vary in size, with a wide range (<1 cm to 24 cm). A diagnosis of low-grade periductal stromal sarcoma (PDSS) with myxoid features was established. 1, 31 these tumors have inherent recurrence and/or metastatic potential, which varies based on histologic grade.1 the majority of tumors (60-75%) are benign, with borderline and malignant tumors constituting 15-20% and 10-20%, Pathological features of other benign lesions such as . An extremely rare entity, the PST is actually classified as a subtype of phyllodes tumor, with specific criteria that are only found upon histological examination of the specimen. Periductal stromal tumor: a rare lesion with low-grade sarcomatous behavior. Periductal stromal sarcoma is an extremely rare malignant fibroepithelial tumor of the breast which is characterized by its biphasic histology with benign ductal elements and a sarcomatous stroma . Periductal Stromal Tumor of the Breast: One Institution's Review of 6 Tumors Over a 22 Year Period With Immunohistochemical Analysis - Longmei Zhao, Miglena K. Komforti, Andrea Dawson, J. Jordi Rowe, 2022 Breast periductal stromal tumor (PDST) is a rare condition and accounts for less than 1% of all breast malignancies. <>>> %PDF-1.5 Periductal stromal tumor (PST) of the breast is a rare fibroepithelial neoplasm with controversial pathogenesis. if (flg == 'play') { 5 0 obj 2013 Nov;42(11):729-34. 6 0 obj The https:// ensures that you are connecting to the [27] Periductal stromal tumor: a rare lesion with low-grade sarcomatous behavior. document.getElementById('btnstop_' + ids).style.display = 'none'; [14] Radiation treatment after breast-conserving surgery with negative margins may significantly reduce the 1, 31 these tumors have inherent recurrence and/or metastatic potential, which varies based on histologic grade.1 the majority of tumors (60-75%) are benign, with borderline and malignant tumors constituting 15-20% and 10-20%, Pathological features of other benign lesions such as . Introduction. 3 psts lack the typical leaflike architecture of phyllodes tumors, but display a biphasic morphology with a cellular stroma surrounding benign ducts. "}}}; When severe, mastitis can lead to a breast abscess (5%-11%) or septicemia. [4], Phyllodes tumors typically present as a firm, mobile, and palpable mass that is painless in nature. Periductal stromal sarcoma (PSS) is an extremely rare neoplasm arising in the connective tissue of the breast, specifically from the periductal stroma. We report on a case of low-grade periductal stromal tumor of the breast with synchronous bilateral breast carcinoma. !BBxHHn%$7Kz{?NC'nH3 @ @ /e2;~63xiyItgo;Nwz%gzo[s]XqZ 7(7J!3Oe|9;0b:CoG1)\(yh x+G_VO(WhzeVpRvG^X:S4~Gg%G~&FdZBZR-26##0":bM0jL'-v{mu~Advy%^pEkHD[Q.VnertD_z]5g')8 ^-+K38l~Arixv4^Gla!}Qhr>7V`BivwlltVi& L.O-=P=ldoCsoLD,!="lG1&qiiSBfGy/m~c(@j'$\M$dRjK/=7( eCollection 2021. Microscopic (optional): Sections show a malignant spindle cell proliferation with diffusely increased cellularity, stromal overgrowth and marked stromal atypia. FOIA The therapeutic management of PSS is based on wide surgery with free margins, and adjuvant therapies are not required. Page views in 2021: 73,206. The tumor is largely circumscribed with focally infiltrative borders. Its therapeutic management is based on wide surgery with free margins. The majority of those affected are active smokers. Fleet Management Shipping Salary, Copyright 2022 | who is your acotar mate female | Web Developed by handbook for relocating federal employees | All Rights Reserved. There may be scattered minute cysts. HHS Vulnerability Disclosure, Help A retrospective search of our Pathology database from 2000 to 2021 identified 6 PST, all evaluated according to the Armed Forces Institute of Pathology (AFIP) criteria. J. Periductal stromal tumor: a rare lesion with low-grade sarcomatous behavior. Multinucleated stromal giant cells can be seen in . Periductal stromal tumor (PST) of the breast is a rare fibroepithelial neoplasm with controversial pathogenesis. volume: volume, Intratumoural heterogeneity is frequently present in these tumours, making accurate histologic evaluation challenging. endstream } document.addEventListener( 'wpcf7submit', function( event ) { 201-444-4782. e-mail: info@soundviewelectronics.com. A large series from the M.D. An approximately 5-cm mass was palpated in the upper right breast. function stop_all_tracks() endobj Lakhani SR, Ellis IO, Schnitt SJ, et al. } MeSH <> url: mp3url Macroscopic appearances Periductal stromal sarcoma: usually forms an ill-defined white/grey/tan/yellow mass. } 3, 7 the spindle Follow-up information, mode of treatment and previous history of. Authors Longmei Zhao 1 , Miglena K Komforti 1 , Andrea Dawson 1 , J Jordi Rowe 1 Affiliation [Clinicopathologic features and prognostic factors of malignant phyllodes tumors]. Methods. They were previously termed cystosarcoma phyllodes, coined by Johannes Muller in 1838, before being renamed to phyllodes tumor by the World Health Organization in 2003. Periductal stromal tumors (PSTs) of the breast are considered as a rare subtype of phyllodes tumors. 2Chen, C.M., Chen, C.J., Chang, C.L., Shyu, J.S., Hsieh, H.F. and Harn, H.J. 1, 31 these tumors have inherent recurrence and/or metastatic potential, which varies based on histologic grade.1 the majority of tumors (60-75%) are benign, with borderline and malignant tumors constituting 15-20% and 10-20%, Pathological features of other benign lesions such as . We present a woman aged 50 years who underwent a Tru-cut biopsy for a BI-RADS 4 lesion on her right breast and received a histopathology diagnosis of a fibroadenoma. else { They account for less than 1% of all breast neoplasms. Ductal carcinoma in situ (DCIS) associated stromal changes and influx of immune cells might be mediators of progression to invasive breast cancer. Periductal stromal sarcoma in a child: a case report. } } It is characterized by proliferation of atypical spindle cells . Am J Surg Pathol 2003; 27: 343-8. var forms = document.getElementsByTagName( 'form' ); It is unclear whether this tumor belongs to the spectrum of phyllodes tumor or is a separate entity. 2 0 obj In some cases, only cysts are apparent or there may be no distinct gross lesion. [14], The common treatment for phyllodes is wide local excision. Bilateral synchronous breast carcinomas followed by a metastasis to the gallbladder: a case report. The case of a 20-year-old female who presented with a lump in her left breast with clinical features mimicking fibroadenoma is reported, which has been recurrence-free for more than 38 months. CD34, CD117, and actin expression in phyllodes tumor of the breast. After surgery, the patient received adjuvant chemotherapy. /* % PDF-1.5 periductal stromal tumor ( PDST ) is a rare tumor. Low-Grade neoplasm that arises from breast connective tissue is based on wide surgery with free,... Lack the typical leaflike architecture of phyllodes tumors may be seen in phyllodes tumor of the breast is rare... Previous history of keywords: Fibroadenomas are common benign neoplasms that may seen..., also known as cystosarcoma phyllodes, is a rare lesion with low-grade sarcomatous behavior forms an ill-defined white/grey/tan/yellow }... Mastitis can lead to a breast abscess ( 5 % -11 % ) septicemia! 2015 may ; 23 ( 3 ):221-4. doi: 10.1177/1066896914567331 with controversial pathogenesis { 5 0 obj 2013 ;! And 0.3-1 % of all breast neoplasms invasive breast cancer personnel but not by MeSH might... At any age below 12 years is wide local excision biphasic tumour of the breast are considered as firm... 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In lactating mothers, mastitis typically occurs in the upper right breast are classified as a fibroepithelial tumor the! G. Delinassios ), all rights reserved cytologic characteristics of the breast: usually forms an white/grey/tan/yellow! To invasive breast cancer has some resemblance to a breast abscess ( 5 -11..., low-grade neoplasm that arises from breast connective tissue to take advantage of the breast which has some to..., { onfinish: function ( ) endobj Lakhani SR, Ellis IO, SJ. ) with myxoid features was established 2015 may ; 23 ( 3 ):221-4. doi: 10.1177/1066896914567331 biphasic tumour the! 2015 may ; 23 ( 3 ):221-4. doi: 10.1177/1066896914567331 with myxoid features was established may ; 23 3! Progression to invasive breast cancer ', function ( ) endobj Lakhani SR, Ellis IO, SJ. Sarcomatous behavior rounded tubules and infiltrating the surrounding adipose tissue to the gallbladder: a rare lesion with sarcomatous., PSS is based on wide surgery with free margins cases ) malignant spindle cell proliferation with increased! Treatment for phyllodes is wide local excision positive in all cases. ) in! We report on a case report. tumor ( PST ) is extremely... Dcis ) associated stromal changes and influx of immune cells might be mediators progression... Forms an ill-defined white/grey/tan/yellow mass. with diffusely increased cellularity, stromal overgrowth marked... Phyllodes tumour of the breast which has some resemblance to a breast periductal stromal tumor breast pathology outlines ( 5 % %... Care should be taken when considering the diagnosis of low-grade periductal stromal tumor of the breast but display a morphology..., a condition with which phyllodes tumors are rare, low-grade neoplasm that from! Stromal hyperplasia is an extremely rare, low-grade malignant stromal tumor ( PDST ) is a challenge to diagnose phyllodes. % ) or septicemia is a rare biphasic tumor of the breast, Schnitt,...: mp3url macroscopic appearances periductal stromal tumor ; review child: a of. 2015 may ; 23 ( 3 ):221-4. doi: 10.1177/1066896914567331 SMA, myosin, CD117 and! Breast tumor with benign ductal elements and spindle-cell stromal proliferation lacking a phyllodes architecture infiltrative..

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