Once more commonly referred to as cystosarcoma phyllodes is a rare, predominantly benign tumor that occurs almost exclusively in the female breast
Grossly, the tumor displays characteristics of a large, malignant sarcoma, takes on a leaf like appearance when sectioned, and displays epithelial, cyst like spaces when viewed histologically.
The tumors can develop in people of any age; however, the median age is the fifth decade of life.
Phyllodes tumor is the most commonly occurring nonepithelial neoplasm of the breast, though it represents only about 1% of tumors in the breast.
It has a smooth, sharply demarcated texture and typically is freely movable. It is a relatively large tumor, with an average size of 5 cm (though lesions larger than 30 cm have been reported).
The etiology of phyllodes tumors is unknown.
Because of limited data, the relative percentages of benign and malignant phyllodes tumors are not well defined. Reports have suggested, however, that about 85% to 90% of phyllodes tumors are benign and that approximately 10% to 15% are malignant.
Although benign phyllodes tumors do not metastasize, they have a tendency to grow aggressively and can recur locally.
Like other sarcomas, malignant phyllodes tumors metastasize hematogenously.
Unfortunately, the pathologic appearance of a phyllodes tumor does not always predict the neoplasm’s clinical behavior; in some cases, therefore, there is a degree of uncertainty about the lesion’s classification.
The characteristics of a malignant phyllodes tumor include the following :
- Recurrent malignant tumors seem to be more aggressive than the original tumor
- The lungs are the most common metastatic site:
- Followed by the bone, heart, and liver
- Symptoms of metastatic involvement can arise from:
- As early as a few months to as late as 12 years after the initial therapy
- Most patients with metastases die within 3 years of the initial treatment
- No cures for systemic metastases exist
- Roughly 30% of patients with malignant phyllodes tumors die of the disease
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