Phyllodes tumor

Phyllodes tumor is a group of circumscribed biphasic neoplasm characterized by a double layered epithelial component arranged in clefts surrounded by an hypercellular mesenchymal component typically organized in a leaf-like structures.

Age group: Mostly occur between 30 and 70 years of age, with a peak in the fifth decade

Origin: it arises from intralobular stroma.

Clinical presentation: Majority are detected as palpable masses

Gross
Benign phyllodes tumor: It is round, sharply circumscribed. the size may vary from few cms to massive involving the entire breast.
Cut surface: Solid, firm, glistening, gray-white bulging mass.
It shows characteristic whorled pattern with curved cleft-like spaces that resemble the leaf-buds
(phyllodes is Greek for “leaflike”).

Malignant phyllodes:
It is usually poorly circumscribed and locally invasive with infiltrative borders.

MICROSCOPY
Growth pattern: Typically show exaggerated intracanalicular growth pattern with leaf-like projections into the dilated lumens.
Two key features:
presence of benign epithelial elements and
stromal hypercellularity

phyllodes tumor -benign

PHYLLODES tumor

 

phyllodes tumor

Grading: Depending on the appearance of the stromal component, phyllodes tumors are divided into
low-grade (benign), borderline and high-grade (malignant) phyllodes.

phyllodes tumor- malignant

Prognosis
Phyllodes tumors are likely to recur if not excised with wide margins. Lymphatic spread is uncommon.
High-grade lesions frequently recur and may also develop hematogenous metastases. Metastatic deposits contain only the stromal component

 

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