Optimising preoperative diagnosis in phyllodes tumour of. A total of 41% were benign phyllodes tumors, 41 % were borderline and 18% malignant. If the phyllodes tumor of the breast is benign or borderline histology, radiation therapy. Pdf 11 212tumor phyllodes jurnal rinaldi zainuddin. Ultrasonography and core needle biopsy in the differential diagnosis of fibroadenoma and tumor phyllodes m.
Apajasarkkinen departments of diagnostic radiology and pathology, oulu university hospital, oulu, finland bode mk, rissanen t, apajasarkkinen m. With the nonoperative management of fibroadenomas widely adopted, the importance of phyllodes tumours today lies in the need to differentiate them from other benign breast lesions. A low magnification of the primary breast phyllodes tumour with a cystic space into which stromal fronds projected. Namanya berasal dari kata yunani sarcoma, yang berarti tumor. A total of 41% were benign phyllodes tumors, 41% were borderline and 18% malignant. Phyllodes tumor pt of the breast in hispanic patients is more frequently reported with large tumors and with more borderlinemalignant subtypes compared.
Phyllodes tumor pt of the breast are rare breast lesions, accounting for less than 1% of all breast tumors. The preoperative diagnosis of phyllodes tumour of the breast continues to challenge pathologist and surgeon alike. Since phyllodes tumors are locally recurrent tumor especially when not excised with a clear margins and very u n p r e d i c t a b l ei ng r o w t ha n dm e t a s t a t i ca c t i v i t y,i ti sv. Phyllodes tumors of the breast are rare, accounting for less than 1% of all breast tumors. Thus, in such cases we recommend ensuring inclusion of the tumor margin by reexcision. Accurate preoperative pathological diagnosis allows correct surgical planning.
The phyllodes tumor, a lesion limited to mammary tissue, was first described by muller in 1838. The mean age of patients at presentation was 41 years range 1567 years. Phyllodes tumors of the breast are rare tumors that start in the connective stromal tissue of the breast. Cytologically, it is often easier to differentiate benign from malignant phyllodes tumors than to separate benign phyllodes tumors from fibroadenomas. Phyllodes tumors are spectrum of tumors ranging from benign to malignant. They account for less than 1% of all breast tumors and display a wide range of biological behaviors, ranging from benign to highly aggressive. Distant metastases in phyllodes tumours of the breast. A free powerpoint ppt presentation displayed as a flash slide show on id. Find out more about the types of tumor and the outlook for people with each type. Rarely some types of benign tumors transform into malignant tumors. Malignant phyllodes tumors of the breast occur infrequently and are difficult to treat with chemotherapy. Cystosarcoma phyllodes adalah jarang, terutama tumor jinak yang terjadi hampir sematamata pada payudara wanita. Sifat ganasnya sendiri adalah hasil dari pertumbuhannya yang bisa sangat cepat dan besar sesuai dengan kondisi masingmasing penderita dan menyebabkan kulit di sekitar. Cancer protocol templates college of american pathologists.
There is no distinct boundary between fibroadenoma and phyllodes tumor at the benign end of the spectrum and both can be excised with breast conservation. Learn more about the symptoms and diagnosis of phyllodes tumors. Tumor phyllodes tergolong dalam tumor yang jinak atau harmless, namun bunda tidak boleh lengah dan menganggapnya remeh karena tumor ini sendiri dapat berubah ganas sewaktuwaktu. It is typically a large, fast growing mass that forms from the periductal stroma of the breast. The classification of pt proposed by the world health organization who into benign, borderline, and malignant is based on a combination of several histologic features, including. It is often underdiagnosed by the pathologists and undertreated by. A phyllodes tumor forms in the breast and tends to grow quickly. Phyllodes tumor of the breast genetic and rare diseases. A tumor is an abnormal mass of tissue that may be benign, premalignant, or cancerous. To be able to give an initial impression of the case to discuss the anatomy and physiology of the breast to differentiate benign from malignant breast mass to present on phyllodes tumor to identify appropriate management objectives. Bab i pendahuluan merupakan neoplasma jinak yang bersifat menyusup secara lokal dan mungkin ganas 1015%. Benign phyllodes tumors are usually diagnosed at a younger age than malignant phyllodes tumors.
She was diagnosed with phyllodes tumor of her breast and treated initially with neoadjuvant chemotherapy and mastectomy. They get their name from the leaflike pattern in which they grow phyllodes means leaflike in greek. Secondary signs of malignancy, such as perifocal edema, skin thickening or nipple retraction were absent at mammography. Phyllodes tumors account for less than 1% of breast neoplasms in contrast to fibroadenomas, which are common. Ultrasonography and core needle biopsy in the differential. Primary breast neoplasms are rare in adolescent females, most of which are benign. Diagnosing phyllodes tumors usually involves a combination of steps, such as a physical exam, a mammogram, and a biopsy. No single feature is reliable to predict clinical behavior of phyllodes tumors. Phyllodes tumors constitute a remarkably small subset of breast neoplasms. A mammogram to obtain xray images of the breast and locate the tumor. Colon protocol has been updated requiring reporting of macroscopic evaluation of mesorectum. They tend to grow quickly, but they rarely spread outside the breast. These tumors are a form of sarcoma because they grow in the connective tissue of the breast, not in the ducts. Enlarged axillary lymph nodes were noted in 1 patient with a phyllodes tumor.
Phyllodes tumours pts of the breast are uncommon fibroepithelial neoplasms, comprising 0. The college of american pathologists february 2020 release includes 47 revised cancer protocols and one new adult autopsy reporting protocol. Ppt phyllodes breast tumor powerpoint presentation. Phyllodes tumor of the breast archives of pathology. Phyllodes tumor bears specic clinical characteristic and can be considered as a di erential diagnosis for the breast lumps. They are most common in women in their 30s and 40s, although women of any age can be affected. Phyllodes tumor pt is a pdf tutorials on computer networking rare fibroepithelial neoplasm of the breast that. Phyllodes tumours are rare fibroepithelial lesions that account for less than 1% of all breast neoplasms. Phyllodes tumors follow up care by jonas wilson, ing.
Here, we present an effective chemotherapy strategy for. Phyllodes tumor of the breast textbook of uncommon. Abstract phyllodes tumors is a rare fibroepithelial neoplasm. As both phyllodes tumors and fibroadenomas belong to a spectrum of fibroepithelial lesions, accurate cytological diagnosis of phyllodes tumors by fine needle aspiration can be difficult. Malignant phyllodes tumor with brain, lung and adrenal metastases at the same time is rare. Phyllodes breast tumor joint hospital surgical grand round 26 april 2014 ng yuen shan, sandy tuen mun hospital triple assessment, in patients with phyllodes tumors. It is a rare condition, with an incidence of 1 in 100,000, and its. They account for less than 1% of all breast neoplasms. Tumor phyllodes meski jarang wajib diwaspadai doktersehat.
Differentiation of phyllodes tumors versus fibroadenomas. Phyllodes tumor page 1 of 4 md anderson cancer center. Symptoms and diagnosis of phyllodes tumors of the breast. The preoperative diagnosis and proper management are crucial in phyllodes tumor because of their tendency to recur and malignant potential in some of these tumors.
Malignant phyllodes tumour with metastasis to the lung. Effective treatment of a malignant breast phyllodes tumor with. Saat ini penamaan yang dipakai adalah menurut world health organisation, 1982 yaitu tumor phyllodes sebagai penamaan yang paling sesuai. Namanya berasal dari kata yunani sarcoma, yang berarti tumor berdaging, dan phyllo, yang berarti daun. Surgical management of phyllodes tumors oncology jama. Phyllodes tumor bears specific clinical characteristic and can be considered as a differential diagnosis for the breast lumps. Similar histologically to a fibroadenoma 1,2 the etiology is still unknown 3 histologically, pts are classified. Distribusi pada usia dibawah 20 tahun juga jarang, jika ada tampilan klinis dan histopatologinya adalah. Most phyllodes tumors are benign not cancerous, some are malignant cancerous, and some are borderline. They are typically seen in women aged 35 to 55 years at presentation and are mostly large with a median size of 4 cm. Pdf optimising preoperative diagnosis in phyllodes tumor. But tumors like adenomatous polyps adenomas in the colon have a greater risk of transforming into malignant tumor.
Phyllodes tumors can occur at any age, but they tend to develop when a woman is in her 40s. In this paper, we describe a case of an adolescent with a phyllodes tumor. Menurut samsuhidajat 2004, tumor jinak payudara terdiri dari. Phyllodes tumors pts, which are rare and mostly benign in nature, are fibroepithelial tumors of the breasts. This cancer is so rare that a confirmation by a second pathologist is required.
Bab i pendahuluan latar belakang cystosarcoma phyllodes asalnya bisa dari fibroadenoma selular yang telah ada yang sekarang mengandung satu atau lebih komponen asal mesenkim. Ultrasoundpathology correlation megan kalambo 1, beatriz e. Nccn guidelines are widely recognized and used as the standard for clinical policy in oncology by clinicans and payors. Phyllodes tumor, also known as cystosarcoma phyllodes, is a rare fibroepithelial tumor of the breast which has some resemblance to a fibroadenoma. The value of fnac in diagnosis of phyllodes tumour remains controversial, but core needle biopsy has high sensitivity and negative predictive.
Cancerous phyllodes tumors are an unusual presentation of breast cancer. The gastrointestinal and breast protocols have been updated to reflect the revised who histologic types. Diagnosis and management of phyllodes tumour of the breast. All breast lumps should be triple assessed and the diagnosis of a phyllodes. They are graded as benign, borderline or malignant based on the world health organisation who classification. Usia pasien adalah 1090 tahun namun yang terbanyak adalah pada kelompok usia 35 55tahun haagensens series. Phyllodes tumor pt of the breast is a rare fibroepithelial neoplasm, accounting for 0. Malignant phyllodes tumor with metastases to lung, adrenal. Scribd is the worlds largest social reading and publishing site. Perbedaan antara tumor filoides dengan fibroadenoma adalah bahwa terdapat pertumbuhan berlebih dari jaringan fibrokonektif pada tumor filoides. Phyllodes tumor of the breast is a rare biphasic fibroepithelial neoplasm that has the potential for recurrence and metastases.
Malignant spectrum pose a management challenge for clinicians due to high risks of recurrence and metastasis. A phyllodes tumor with a positive surgical margin diagnosed based on excisional biopsy is likely to have a high local recurrence rate, particularly in cases with stromal overgrowth and a malignant tumor. Formerly called cystosarcoma phyllodes, is a breast fibroepithelial neoplasm. Missed diagnosis of phyllodes tumor and its implications. Your doctor may be able to feel the lump in the breast, or you may feel it yourself during a breast selfexam.
Tumor filoides adalah tipe yang jarang dari tumor payudara, yang hampir sama dengan fibroadenoma yaitu terdiri dari dua jaringan, jaringan stroma dan glandular. Insiden tumor phyllodes adalah jarang dan merupakan 0,31% dari tumor payudara wanita. Analisis ekspresi cd117 dan ki67 pada tumor phyllodes benign majalah patologi fetty fatimah, sjahjenny mustokoweni, alphania rahniayu vol. On a mammogram, a phyllodes tumor appears as a large round or oval mass with welldefined edges. The stroma is markedly cellular and the stromal cells show marked nuclear pleomorphism. The classification of pt proposed by the world health. The most common symptom of a phyllodes tumor is a painless breast lump that you or your doctor can feel while examining the breasts. They usually occur in middleaged to elderly women but can occur at any age. Phyllodes tumours are rare fibroepithelial lesions. Distinction between phyllodes tumor and fibroadenoma in.
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