Abstract

Case Presentation

Patient with Fibroadenoma on Biopsy, Found to have Phyllodes on Final Pathology: A Case Report

Niharika Singh*, Pons Materum, Artemio Zavala, Riddhish Sheth and Edna Kapenhas

Published: 28 December, 2023 | Volume 7 - Issue 3 | Pages: 083-086

Distinguishing between fibroadenomas and phyllodes tumors is a challenge in breast surgery, despite advances in both radiology and pathology. In this case report, we analyze a patient presenting with a breast mass with multiple core needle biopsy results consistent with fibroadenoma, who underwent enucleation and was found to have phyllodes tumor on final pathology, thereby requiring surgical re-excision. This case report highlights the importance of patient clinical presentation in differentiating fibroadenomas and phyllodes tumors and explores how to achieve appropriate margins upon surgical re-excision after prior enucleation of phyllodes tumor via ultrasound localization of a seroma.

Read Full Article HTML DOI: 10.29328/journal.acr.1001085 Cite this Article Read Full Article PDF

Keywords:

Phyllodes tumor; Fibroadenomas; Breast surgery; Surgical excision

References

  1. Pareja F, Geyer FC, Kumar R, Selenica P, Piscuoglio S, Ng CKY, Burke KA, Edelweiss M, Murray MP, Brogi E, Weigelt B, Reis-Filho JS. Phyllodes tumors with and without fibroadenoma-like areas display distinct genomic features and may evolve through distinct pathways. NPJ Breast Cancer. 2017 Oct 12;3:40. doi: 10.1038/s41523-017-0042-6. PMID: 29043292; PMCID: PMC5638820.
  2. Tan BY, Acs G, Apple SK, Badve S, Bleiweiss IJ, Brogi E, Calvo JP, Dabbs DJ, Ellis IO, Eusebi V, Farshid G, Fox SB, Ichihara S, Lakhani SR, Rakha EA, Reis-Filho JS, Richardson AL, Sahin A, Schmitt FC, Schnitt SJ, Siziopikou KP, Soares FA, Tse GM, Vincent-Salomon A, Tan PH. Phyllodes tumours of the breast: a consensus review. Histopathology. 2016 Jan;68(1):5-21. doi: 10.1111/his.12876. PMID: 26768026; PMCID: PMC5027876.
  3. Oprić S, Oprić D, Gugić D, Granić M. Phyllodes tumors and fibroadenoma common beginning and different ending. Coll Antropol. 2012 Mar;36(1):235-41. PMID: 22816226.
  4. Wiratkapun C, Piyapan P, Lertsithichai P, Larbcharoensub N. Fibroadenoma versus phyllodes tumor: distinguishing factors in patients diagnosed with fibroepithelial lesions after a core needle biopsy. Diagn Interv Radiol. 2014 Jan-Feb;20(1):27-33. doi: 10.5152/dir.2013.13133. PMID: 24356293; PMCID: PMC4463252.
  5. Tummidi S, Kothari K, Agnihotri M, Naik L, Sood P. Fibroadenoma versus phyllodes tumor: a vexing problem revisited! BMC Cancer. 2020 Jul 13;20(1):648. doi: 10.1186/s12885-020-07129-0. PMID: 32660435; PMCID: PMC7359567.
  6. Duman L, Gezer NS, Balcı P, Altay C, Başara I, Durak MG, Sevinç AI. Differentiation between Phyllodes Tumors and Fibroadenomas Based on Mammographic Sonographic and MRI Features. Breast Care (Basel). 2016 Apr;11(2):123-7. doi: 10.1159/000444377. Epub 2016 Mar 23. PMID: 27239174; PMCID: PMC4881274.
  7. Wurdinger S, Herzog AB, Fischer DR, Marx C, Raabe G, Schneider A, Kaiser WA. Differentiation of phyllodes breast tumors from fibroadenomas on MRI. AJR Am J Roentgenol. 2005 Nov;185(5):1317-21. doi: 10.2214/AJR.04.1620. PMID: 16247156.
  8. Niu S, Huang J, Li J, Liu X, Wang D, Wang Y, Shen H, Qi M, Xiao Y, Guan M, Li D, Liu F, Wang X, Xiong Y, Gao S, Wang X, Yu P, Zhu J. Differential diagnosis between small breast phyllodes tumors and fibroadenomas using artificial intelligence and ultrasound data. Quant Imaging Med Surg. 2021 May;11(5):2052-2061. doi: 10.21037/qims-20-919. PMID: 33936986; PMCID: PMC8047381.
  9. Stoffel E, Becker AS, Wurnig MC, Marcon M, Ghafoor S, Berger N, Boss A. Distinction between phyllodes tumor and fibroadenoma in breast ultrasound using deep learning image analysis. Eur J Radiol Open. 2018 Sep 24;5:165-170. doi: 10.1016/j.ejro.2018.09.002. PMID: 30258856; PMCID: PMC6154513.
  10. Zhang L, Yang C, Pfeifer JD, Caprioli RM, Judd AM, Patterson NH, Reyzer ML, Norris JL, Maluf HM. Histopathologic, immunophenotypic, and proteomics characteristics of low-grade phyllodes tumor and fibroadenoma: more similarities than differences. NPJ Breast Cancer. 2020 Jun 26;6:27. doi: 10.1038/s41523-020-0169-8. PMID: 32613078; PMCID: PMC7319981.
  11. Komenaka IK, El-Tamer M, Pile-Spellman E, Hibshoosh H. Core needle biopsy as a diagnostic tool to differentiate phyllodes tumor from fibroadenoma. Arch Surg. 2003 Sep;138(9):987-90. doi: 10.1001/archsurg.138.9.987. PMID: 12963656.
  12. Mangi AA, Smith BL, Gadd MA, Tanabe KK, Ott MJ, Souba WW. Surgical management of phyllodes tumors. Arch Surg. 1999 May;134(5):487-92; discussion 492-3. doi: 10.1001/archsurg.134.5.487. PMID: 10323420.
  13. Guillot E, Couturaud B, Reyal F, Curnier A, Ravinet J, Laé M, Bollet M, Pierga JY, Salmon R, Fitoussi A; Breast Cancer Study Group of the Institut Curie. Management of phyllodes breast tumors. Breast J. 2011 Mar-Apr;17(2):129-37. doi: 10.1111/j.1524-4741.2010.01045.x. Epub 2011 Jan 19. PMID: 21251125.
  14. Simpson A, Li P, Dietz J. Diagnosis and management of phyllodes tumors of the breast. Annals of Breast Surgery. 2021; 5. https://abs.amegroups.org/article/view/6572
  15. Nguyen QD, Krider SO, Roberts JT, Posleman Monetto FE, He J. Fibroepithelial Lesion Initially Believed to Be Fibroadenoma, but Interval Growth Consistent With Phyllodes Tumor. Cureus. 2020 Sep 10;12(9):e10363. doi: 10.7759/cureus.10363. PMID: 33062486; PMCID: PMC7549856.

Figures:

Figure 1

Figure 1

Figure 1

Figure 2

Figure 1

Figure 3

Figure 1

Figure 4

Figure 1

Figure 5

Figure 1

Figure 6

Similar Articles

  • Giant Lipoma Anterior Neck: A case report
    Manu CB*, Gowri Sankar M and Arun Alexander Manu CB*,Gowri Sankar M,Arun Alexander. Giant Lipoma Anterior Neck: A case report . . 2017 doi: 10.29328/journal.hjcr.1001003; 1: 006-008
  • Local recurrence after enlarged total nephrectomy
    Walid Bai*, Messian Gallouo, Dakir Mohammed, Adil Debbagh, Rachid Aboutaieb and Mahdi Graiouid Walid Bai*,Messian Gallouo,Dakir Mohammed,Adil Debbagh,Rachid Aboutaieb,Mahdi Graiouid. Local recurrence after enlarged total nephrectomy. . 2019 doi: 10.29328/journal.acr.1001012; 3: 005-008
  • Cutaneous metastasis of a tumor of the excretrial tract
    Nizar Cherni, Abdallah Chaachou, Wael Ferjaoui*, Mohamed Dridi and Samir Ghozzi Nizar Cherni,Abdallah Chaachou,Wael Ferjaoui*,Mohamed Dridi,Samir Ghozzi. Cutaneous metastasis of a tumor of the excretrial tract. . 2022 doi: 10.29328/journal.acr.1001060; 6: 015-016
  • Patient with Fibroadenoma on Biopsy, Found to have Phyllodes on Final Pathology: A Case Report
    Niharika Singh*, Pons Materum, Artemio Zavala, Riddhish Sheth and Edna Kapenhas Niharika Singh*,Pons Materum,Artemio Zavala,Riddhish Sheth,Edna Kapenhas. Patient with Fibroadenoma on Biopsy, Found to have Phyllodes on Final Pathology: A Case Report. . 2023 doi: 10.29328/journal.acr.1001085; 7: 083-086

Recently Viewed

Read More

Most Viewed

Read More

Help ?