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Ureteral tumor with morphological features analogous to phyllodes tumor: a unique case with concomitant urothelial carcinoma. Diagn Pathol 2022; 17:94. [PMID: 36564794 PMCID: PMC9784280 DOI: 10.1186/s13000-022-01277-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 12/19/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Phyllodes tumors belong to a spectrum of biphasic fibroepithelial lesions and are most commonly found in the breast. They are extremely rare in the urinary tract and only one case of bladder phyllodes tumor has been reported. CASE PRESENTATION We present a 69-year-old man with gross hematuria without an apparent cause. Computed tomography-urography and cystoscopic examination revealed a 5 × 4 cm lesion in the right ureteral orifice. He underwent a laparoscopic nephroureterectomy and partial cystectomy. Postoperative pathology confirmed a leaf-like structure consisting of myxoid stroma and peripheral urothelium. Stromal cells were spindle-shaped and stellate in appearance with no conspicuous cytological atypia or mitosis. The outlining urothelium had varying degrees of dysplasia, while in areas with moderate-to-severe dysplasia, active mitotic activity, abnormal giant cells, and focal early infiltration were observed. Overall, this case had the morphological features of benign phyllodes tumors and concomitant invasive urothelial carcinoma inside. The patient remained disease-free at 7 months after surgery. CONCLUSION We report the first ureteral tumor with the morphological characteristics of a phyllodes tumor and concomitant invasive urothelial carcinoma inside. Considering the potential for local recurrence of phyllodes tumors and invasive urothelial carcinoma, long-term clinical and radiological follow-up of such lesions are advisable.
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Wu J, Sun KW, Mo QP, Yang ZR, Chen Y, Zhong MC. Preoperational diagnosis and management of breast ductal carcinoma in situ arising within fibroadenoma: Two case reports. World J Clin Cases 2022; 10:3496-3504. [PMID: 35611194 PMCID: PMC9048540 DOI: 10.12998/wjcc.v10.i11.3496] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 12/05/2021] [Accepted: 02/27/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Ductal carcinoma in situ (DCIS) arising within fibroadenoma is a type of tumor that is rarely encountered in clinic, with only about 100 cases of carcinoma arising within a fibroadenoma reported in the literature. Here, we present two cases of breast DCIS arising within a fibroadenoma and discuss their clinical and imaging findings as well as treatment.
CASE SUMMARY The patients did not have cancer-related personal and family histories. Case 1 (a 49-year-old woman) was diagnosed with a bilateral breast nodule in May 2018 and was followed (preoperative imaging data including ultrasound and mammography) for 3 years; she underwent an excisional biopsy to address an enlargement in nodule size. Case 2 (a 37-year-old woman) was diagnosed with a left breast nodule in June 2021 and consequently received vacuum-assisted biopsy of the tumor which appeared as “irregularly shaped” and “unevenly textured” tissue on ultrasound. The pathological diagnosis was clear in both cases. Both patients underwent breast-conserving surgery and sentinel lymph node biopsy. The two cases received or planned to receive radiotherapy as well as endocrine therapy (tamoxifen).
CONCLUSION Breast DCIS arising within a fibroadenoma is rare, but patients treated with radiotherapy and endocrine therapy can have good prognosis.
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Affiliation(s)
- Jun Wu
- Department of Breast Surgery, Zhejiang Provincial People’s Hospital, People’s Hospital of Hangzhou Medical College, Hangzhou 310014, Zhejiang Province, China
- Cancer Center, Zhejiang Provincial People’s Hospital, People’s Hospital of Hangzhou Medical College, Hangzhou 310014, Zhejiang Province, China
| | - Ke-Wang Sun
- Department of Breast Surgery, Zhejiang Provincial People’s Hospital, People’s Hospital of Hangzhou Medical College, Hangzhou 310014, Zhejiang Province, China
- Cancer Center, Zhejiang Provincial People’s Hospital, People’s Hospital of Hangzhou Medical College, Hangzhou 310014, Zhejiang Province, China
| | - Qiu-Ping Mo
- Department of Breast Surgery, Zhejiang Provincial People’s Hospital, People’s Hospital of Hangzhou Medical College, Hangzhou 310014, Zhejiang Province, China
- Cancer Center, Zhejiang Provincial People’s Hospital, People’s Hospital of Hangzhou Medical College, Hangzhou 310014, Zhejiang Province, China
| | - Ze-Ran Yang
- Cancer Center, Zhejiang Provincial People’s Hospital, People’s Hospital of Hangzhou Medical College, Hangzhou 310014, Zhejiang Province, China
- Department of Pathology, Zhejiang Provincial People’s Hospital, People’s Hospital of Hangzhou Medical College, Hangzhou 310014, Zhejiang Province, China
| | - Yuan Chen
- Cancer Center, Zhejiang Provincial People’s Hospital, People’s Hospital of Hangzhou Medical College, Hangzhou 310014, Zhejiang Province, China
- Department of Pathology, Zhejiang Provincial People’s Hospital, People’s Hospital of Hangzhou Medical College, Hangzhou 310014, Zhejiang Province, China
| | - Miao-Chun Zhong
- Department of Breast Surgery, Zhejiang Provincial People’s Hospital, People’s Hospital of Hangzhou Medical College, Hangzhou 310014, Zhejiang Province, China
- Cancer Center, Zhejiang Provincial People’s Hospital, People’s Hospital of Hangzhou Medical College, Hangzhou 310014, Zhejiang Province, China
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Brahmachari S, Kumari M, Sharma T, Jagtap MB. Synchronous Luminal A Ductal Carcinoma In Situ in a Recurrent Benign Phyllodes Tumor Diagnosed Preoperatively: An Unusual Presentation of a Rare Neoplasm. Cureus 2022; 14:e23225. [PMID: 35308191 PMCID: PMC8926381 DOI: 10.7759/cureus.23225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/16/2022] [Indexed: 11/05/2022] Open
Abstract
Phyllodes tumor (PT) is a rare benign tumor of the breast with a propensity to recur and metastasize. Ductal carcinoma in situ (DCIS) within PT is an extremely rare finding and is usually diagnosed postoperatively. We present a case of a 36-year-old female with a recurrent lump in her left breast diagnosed as a benign PT. Preoperatively, aspiration cytology revealed DCIS within the known case of recurrent PT. Emergency left modified radical mastectomy was performed due to an uncontrolled sudden hemorrhage from the tumor. Postoperatively, hormonal therapy was started based on immuno-histopathological findings. DCIS in PT is not encountered frequently and hence no standard management protocol exists for such cases, but when detected by histopathology, the clinical management and prognosis have to undergo a complete change. Preoperative diagnosis and proper individualized management by a multidisciplinary team that ensures clear surgical margins and planned adjuvant therapy play a crucial role in preventing the recurrence of DCIS within PT.
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Park HM, Lim HS, Ki SY, Lee HJ, Lee JS, Park MH. Invasive Ductal Carcinoma Originating from a Borderline Phyllodes Tumor in a Young Female: A Case Report. JOURNAL OF THE KOREAN SOCIETY OF RADIOLOGY 2021; 82:971-976. [PMID: 36238057 PMCID: PMC9514403 DOI: 10.3348/jksr.2020.0155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 09/29/2020] [Accepted: 10/19/2020] [Indexed: 11/17/2022]
Abstract
유방 엽상종양은 전체 유방 종양의 1% 미만을 차지하는 드문 섬유상피종양이다. 엽상종양은 유관주위 버팀질 세포에서 기원하여 상피 성분과 버팀질 성분을 모두 포함하는 특징을 가지며, 조직학적으로 양성, 경계성, 악성으로 구분된다. 엽상종양의 상피 성분에서 암이 발생하는 것은 매우 드물기 때문에 이에 대한 영상의학적 소견은 명확히 정립된 바가 없다. 이에 저자들은 21세 젊은 여성에서 경계성 엽상종양 내에서 생긴 침윤성 유관암을 경험하였기에 자기공명영상을 포함한 영상의학적 소견과 조직병리학적 소견을 보고하고자 한다.
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Affiliation(s)
- Hye Mi Park
- Department of Radiology, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Hwasun, Korea
| | - Hyo Soon Lim
- Department of Radiology, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Hwasun, Korea
| | - So Yeon Ki
- Department of Radiology, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Hwasun, Korea
| | - Hyo-jae Lee
- Department of Radiology, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Hwasun, Korea
| | - Ji Shin Lee
- Department of Pathology, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Hwasun, Korea
| | - Min Ho Park
- Department of Surgery, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Hwasun, Korea
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Bouri S, Simon P, D'Haene N, Catteau X, Noël JC. Invasive ductal carcinoma arising in borderline phyllode tumor: A potential role of PIK3CA mutation. Int J Surg Case Rep 2020; 77:701-703. [PMID: 33395878 PMCID: PMC7711183 DOI: 10.1016/j.ijscr.2020.10.134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 10/28/2020] [Accepted: 10/29/2020] [Indexed: 12/02/2022] Open
Abstract
Invasive carcinomatous lesions associated with borderline phyllodes tumors are extremely rare. Molecular biological mechanisms associated with this kind of lesions are unknown. PIK3CA gene mutation could be implicated in the development of these lesions.
Introduction Carcinomatous lesions associated with phyllodes tumors are extremely rare and are found in less than 1% of all cases. To date, the molecular biological mechanisms associated with this carcinomatous transformation remain unknown. Presentation of case We present here the case of a 61-year-old patient with invasive ductal of no special type (NST) carcinoma originating in a borderline phyllode tumor with mutation in the PIK3CA gene. Discussion To the best of our knowledge, this mutation has never been described in this type of association. Conclusion Based on these data, we can better understand the ethiopathogenic molecular mechanisms in this type of lesion. Consequently, they could also in the future give rise to new therapeutic alternatives.
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Affiliation(s)
- Sarah Bouri
- Department of Pathology, Erasme University Hospital, Université Libre de Bruxelles, Brussels, Belgium; Centre Universitaire Inter Regional d'Expertise en Anatomie Pathologique Hospitalière (CurePath), Jumet, Belgium.
| | - Philippe Simon
- Department of Gynecology, Erasme University Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - Nicky D'Haene
- Department of Pathology, Erasme University Hospital, Université Libre de Bruxelles, Brussels, Belgium; Centre Universitaire Inter Regional d'Expertise en Anatomie Pathologique Hospitalière (CurePath), Jumet, Belgium
| | - Xavier Catteau
- Department of Pathology, Erasme University Hospital, Université Libre de Bruxelles, Brussels, Belgium; Centre Universitaire Inter Regional d'Expertise en Anatomie Pathologique Hospitalière (CurePath), Jumet, Belgium
| | - Jean-Christophe Noël
- Department of Pathology, Erasme University Hospital, Université Libre de Bruxelles, Brussels, Belgium; Centre Universitaire Inter Regional d'Expertise en Anatomie Pathologique Hospitalière (CurePath), Jumet, Belgium
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