Breast; Breast Pathology; Breast Cancer; Introduction. Core-needle biopsy revealed bilateral breast carcinoma. Periductal stromal tumor (PST) of the breast is a rare fibroepithelial neoplasm with controversial pathogenesis. The cytologic characteristics of the mesenchymal elements are virtually identical to those seen in phyllodes tumors (PT . 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 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 . Burga, A.M. and Tavassoli, F.A. Care should be taken when considering the diagnosis of fibroadenoma based only on clinical, radiological, and biopsy findings. MeSH phyllodes tumors are rare, comprising 2.5% of fibroepithelial lesions and 0.3-1% of all primary breast tumors. HHS Vulnerability Disclosure, Help var callback = divs[ j ].getAttribute( 'data-callback' ); It is characterized by proliferation of atypical spindle cells . It is characterized by proliferation of atypical spindle cells . Periductal stromal condensation may be seen; Frankly sarcomatous stroma may be seen in malignant phyllodes tumor . The epithelial component was intensely positive in all cases.). Some cases may be associated with fibrocystic changes or atypical ductal hyperplasia (DIN 1c). PMID: 30610048 Abstract Periductal stromal hyperplasia is an exceedingly rare biphasic breast tumor with benign ductal elements and spindle-cell stromal proliferation lacking a phyllodes architecture. The 3rd edition terminology of 'periductal stromal sarcoma' is revised to 'periductal stromal tumour', akin to the widespread consensus to avoid the use of the term 'cystosarcoma' in the context of phyllodes tumours. //soundManager.stop('btnplay_'+ids); 12 years' experience]. if ( expired_callback && 'function' == typeof window[ expired_callback ] ) { Int J Surg Pathol. 2021 Feb;29(1):97-101. doi: 10.1177/1066896920929086. HHS Vulnerability Disclosure, Help Macroscopic appearances Periductal stromal sarcoma: usually forms an ill-defined white/grey/tan/yellow mass. the histologic features of periductal stromal sarcoma were defined as 1) a predominantly spindle cell stromal proliferation of variable cellularity and atypia around open tubules and ducts devoid of a phyllodes pattern, 2) one or more often multiple nodules separated by adipose tissue, 3) stromal mitotic activity of >/=3/10 high power fields, and Imaging Periductal stromal sarcoma (PSS) is an extremely rare neoplasm arising in the connective tissue of the breast, specifically from the periductal stroma. 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 and her final diagnosis was a periductal stromal tumor is presented. case 'mail_sent': Periductal stromal condensation may be seen Frankly sarcomatous stroma may be seen in malignant phyllodes tumor Heterologous differentiation may occur in malignant phyllodes tumor Liposarcoma Osteosarcoma Chondrosarcoma Rhabdomyosarcoma Grading determined by presence or absence of atypical stromal features Kristin C Jensen MD kjensen1@stanford.edu function play_mp3(flg, ids, mp3url, volume, loops) function loopSound(soundID) Younger women have a higher chance of having a benign phyllodes tumor. As far as we know, only sporadic cases were reported (1) (2)(3)(4)(5)(6)(7)(8 . Shows a combination of pericanalicular and intracanalicular epithelial patterns, Relatively uniform stromal cellularity, no subepithelial condensation, Overlap in stromal cellularity and mitosis in cellular and juvenile fibroadenomas, Spindle cells arranged in long sweeping fascicles, Epithelial component often harbors in situ or invasive carcinomatous components, Malignant heterologous element can be present, Lacks marked atypia and stromal giant cells, Very low incidence relative to malignant heterologous differentiation in phyllodes tumor and metaplastic carcinoma; correlate with clinical history, Immunohistochemistry not helpful in differentiation, Involvement by low grade ductal carcinoma in situ, Small focus of osteosarcomatous differentiation. The .gov means its official. Mediawiki Visual Editor Extension, [Clinicopathologic features and prognostic factors of malignant phyllodes tumors]. [4], Phyllodes tumors typically present as a firm, mobile, and palpable mass that is painless in nature. } 2014 Sep 15;7(10):7042-8. eCollection 2014. This site needs JavaScript to work properly. 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 . Scattered stromal mitotic figures are noted. They account for less than 1% of all breast neoplasms. [14], The common treatment for phyllodes is wide local excision. Periductal stromal tumor: the periductal stromal tumor is an entity that histologically overlaps with malignant phyllodes tumor, the main difference being the absence of leaf-like processes. Copyright PathologyOutlines.com, Inc. Click, 30100 Telegraph Road, Suite 408, Bingham Farms, Michigan 48025 (USA). An approximately 5-cm mass was palpated in the upper right breast. var pattern = /(^|\s)g-recaptcha(\s|$)/; Classification of breast lesions is an evolving process . id: 'btnplay_' + ids, Number of Pages:263. 'size': divs[ j ].getAttribute( 'data-size' ), if (pieces.length > 1) {//We have got an .ogg file too histologic criteria for pss according to the afip include: predominantly sarcomatous spindle cell stromal proliferation around open ducts and tubules, lack of leaf-like growth pattern, one or more nodules that can be separated by adipose tissue, mitotic activity equal to or more than 3 in 10 hpf and infiltration into surrounding adipose tissue ( Its therapeutic management is based on wide surgery with free margins. NCI CPTC Antibody Characterization Program. PubMed Search: Phyllodes tumor of the breast[TI] full text[SB] pathology. sharing sensitive information, make sure youre on a federal var recaptchaCallback = function() { Methods. These rare fibroepithelial lesions display a biphasic morphology, characterized by a cellular stroma surrounding benign ducts. Zhonghua Bing Li Xue Za Zhi. soundManager.play('btnplay_' + ids, { We included 472 patients with DCIS. var recaptchaWidgets = []; Macroscopic appearances Periductal stromal sarcoma: usually forms an ill-defined white/grey/tan/yellow mass. }, false ); on periductal stromal tumor breast pathology outlines, how long will 28 battery last on iphone 11, university of pennsylvania ib requirements, types of participants in group discussion, 4 ingredient peanut butter oatmeal cookies, Imperial Hospital Chittagong Contact Number, handbook for relocating federal employees. 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 made of spindle cells and lacking phyllodes architecture. Epub 2011 May 12. HHS Vulnerability Disclosure, Help Pre-operative diagnosis is difficult because it reveals similar symptoms with other benign and malignant tumors with absence of specific This is a tumour of adult women, usually peri- or post-menopausal (a decade older than the median for phyllodes tumour). Methods. Masbah O, Lalya I, Mellas N, et al. 1 0 obj Keywords: case 'spam': PDSS is a distinct low-grade breast sarcoma, the appropriate diagnosis of which requires extensive tumor sampling and additional broad immunohistochemistry. Classification of breast lesions is an evolving process . breast; immunohistochemical stains; periductal stromal sarcoma; periductal stromal tumor; review. Despite their rarity, PTs are an important clinical problem due to their . }}); var wpcf7 = {"apiSettings":{"root":"http:\/\/www.soundviewelectronics.com\/wp-json\/","namespace":"contact-form-7\/v1"},"recaptcha":{"messages":{"empty":"Please verify that you are not a robot. Page views in 2021: 73,206. Misa Los Angeles Black Dress, Authors Longmei Zhao 1 , Miglena K Komforti 1 , Andrea Dawson 1 , J Jordi Rowe 1 Affiliation 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 hyperplasia: the periductal stromal proliferation is bland, with no, or minimal, atypia. An approximately 5-cm mass was palpated in the upper right breast. Occurrence is most common between the ages of 40 and 50, prior to menopause. Introduction: Fibroadenomas (FAs) and phyllodes tumors (PTs) are less prevalent but allied to have malignant transformation in many instances. var expired_callback = divs[ j ].getAttribute( 'data-expired-callback' ); Page views in 2022 to date: 72,633. . 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 (. 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