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 It is characterized by proliferation of atypical spindle cells . 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 . A retrospective search of our Pathology database from 2000 to 2021 identified 6 PST, all evaluated according to the Armed Forces Institute of Pathology (AFIP) criteria. <> Bookshelf soundManager.pause('btnplay_' + ids); Two cases of low-grade periductal stromal sarcoma were classified as benign phyllodes tumors for statistical purposes. However, we cannot answer medical or research questions or give advice. Imaging Features of Breast Periductal Stromal Tumor: A Case Report. Bethesda, MD 20894, Web Policies /* ]]> */ Two cases of low-grade periductal stromal sarcoma were classified as benign phyllodes tumors for statistical purposes. The presence of stromal changes, signs of regression, and . It is non-circumscribed, consisting of spindle-cell proliferation localized around open tubules. 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. 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. DOI: 10.1016/j.path.2017.09.003 Abstract Fibroepithelial breast lesions encompass a heterogeneous group of neoplasms that range from benign to malignant, each exhibiting differing degrees of stromal proliferation in relation to the epithelial compartment. Bilateral synchronous breast carcinomas followed by a metastasis to the gallbladder: a case report. Periductal Stromal Sarcoma of the Breast With Liposarcomatous Differentiation: A Case Report With 10-Year Follow-up and Literature Review. [Clinicopathologic features and prognostic factors of malignant phyllodes tumors]. Periductal stromal sarcoma in a child: a case report. Unable to load your collection due to an error, Unable to load your delegates due to an error. Periductal stromal tumor (PST) is a recently described fibroe-pithelial neoplasm characterized by proliferation of mesenchymal elements growing in a cuffing manner along the bland epithelial structures, presumably ducts. Some regard tumors with predominant periductal stromal expansion (i.e., periductal stromal tumor) as a distinct subtype of phyllodes tumor } } break; Unlike phyllodes tumors, they do not present . The tumor shows infiltrative borders. J Periductal stromal sarcoma (PSS) is an extremely rare neoplasm arising in the connective tissue of the breast, specifically from the periductal stroma. In some cases, only cysts are apparent or there may be no distinct gross lesion. PSS is a distinct, low-grade breast sarcoma with no clinical or radiological specificity. We included 472 patients with DCIS. if (flg == 'play') { Keywords: It is characterized by proliferation of atypical spindle cells surrounding benign mammary ducts and infiltrating adjacent adipose tissue. } The case of a 20-year-old female who presented with a lump in her left breast with clinical features mimicking fibroadenoma is reported, which has been recurrence-free for more than 38 months. 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 Periductal stromal tumor (PST) is an extremely rare, low-grade neoplasm that arises from breast connective tissue. Conclusion. In this study, we describe the case of a 48-year-old female who presented with a palpable mass in the Phyllodes Tumor of the Breast. { Periductal stromal tumor (PDST) is a rare biphasic tumor of the breast that exhibits low-grade malignancy and intermediate behavior. Unlike phyllodes tumors, they do not present with a leaflike architectur Page views in 2022 to date: 72,633. . Periductal mastitis is most common in younger, reproductive-age women. The other had lung metastases, presumably from an angiosarcomatous component. Phyllodes Tumor of the Breast Definition Mixed epithelial and stromal/mesenchymal proliferation of breast characterized by increased stromal cellularity and characteristic broad "leaf-like" papillae inserted into cleft-like spaces Alternate/Historical Names Cystosarcoma phyllodes Diagnostic Criteria Usually large and grossly circumscribed It is a challenge to diagnose the phyllodes by conventional trucut biopsy technique. We studied the interaction between DCIS-associated stromal changes, and immune cell distribution and composition in a well-characterized patient cohort. Where there is extension into lobules, the lobular architecture is preserved. and transmitted securely. [16] The authors of a 2012 study have derived a risk calculator for relapse risk of phyllodes tumors after surgery. and transmitted securely. The spindle cells showed bland nuclei, no visible mitoses, no leaflike growth pattern, and low Ki-67(<1%). endobj 2021 Feb;29(1):97-101. doi: 10.1177/1066896920929086. Zagouri F, Sergentanis TN, Koulocheri D, Nonni A, Bousiotou A, Domeyer P, Michalopoulos NV, Dardamanis D, Konstadoulakis MM, Zografos GC. 2014 Jul;21(4):500-3. doi: 10.1007/s12282-011-0271-8. function stop_all_tracks() We present 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. This site needs JavaScript to work properly. //set the file URL to be an array with the mp3 and ogg file mp3url = new Array(mp3file, oggfile); The epithelial component was intensely positive in all cases.). "}}}; MeSH Breast cancer: abemaciclib (pending) atezolizumab histologic grading hormonal therapy inflammatory molecular subtypes multigene products neoadjuvant chemotherapy pertuzumab radiation therapy & cryoprobe spread and metastases trastuzumab triple negative breast cancer. 4 0 obj Periductal stromal tumors (PSTs) of the breast are considered as a rare subtype of phyllodes tumors. Younger women have a higher chance of having a benign phyllodes tumor. 2 0 obj 8 0 obj Which of the following features can be seen in malignant phyllodes tumors but not metaplastic carcinomas? Am J Surg Pathol 2003; 27: 343-8. . Phyllodes tumor, also known as cystosarcoma phyllodes, is a rare fibroepithelial tumor of the breast which has some resemblance to a fibroadenoma. It is typically a large, fast growing mass that forms from the periductal stroma of the breast 13. These rare fibroepithelial lesions display a biphasic morphology, characterized by a cellular stroma surrounding benign ducts. 'theme': divs[ j ].getAttribute( 'data-theme' ), 2Chen, C.M., Chen, C.J., Chang, C.L., Shyu, J.S., Hsieh, H.F. and Harn, H.J. Masbah O, Lalya I, Mellas N, et al. It is a challenge to diagnose the phyllodes by conventional trucut biopsy technique. Text Editor In Php W3schools, 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. Rare sites of metastasis, such as to the parotid region, have also been described.[13]. local recurrence rate for borderline and malignant tumors. 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 majority of those affected are active smokers. The stromal proliferation is of low cellularity and the stromal cells show mild atypia. endobj Periductal stromal sarcoma in a child: a case report. Periductal stromal tumor (PDST) is a rare biphasic tumor of the breast that exhibits low-grade malignancy and intermediate behavior. Phyllodes tumors (from Greek: phullon), are a rare type of biphasic fibroepithelial mass that form from the periductal stromal and epithelial cells of the breast. PubMed Search: Phyllodes tumor of the breast[TI] full text[SB] pathology. }, 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. Classification of breast lesions is an evolving process . Fibroadenomas are common benign neoplasms that may be treated conservatively. Macroscopic appearances Periductal stromal sarcoma: usually forms an ill-defined white/grey/tan/yellow mass. endstream Periductal stromal tumor: a rare lesion with low-grade sarcomatous behavior. Before Imperial Hospital Chittagong Contact Number, It has biphasic morphology with benign ducts and a sarcomatous stroma with no specific clinical or radiologic findings, which makes it difficult to diagnose (1-4).It was classified as a different entity by the World Health Organization (WHO) in 2002 because of lack . 5 0 obj 2008 Jan;52(1):45-57. doi: 10.1111/j.1365-2559.2007.02893.x. Page views in 2023 to date: 3,585. . Copyright 2014 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved. However, PDSS and PDSH may or may not form masses and vary in size, with a wide range (<1 cm to 24 cm). 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. } Periductal stromal hyperplasia is an exceedingly rare biphasic breast tumor with benign ductal elements and spindle-cell stromal proliferation lacking a phyllodes architecture. [6] In addition, larger masses can stretch the overlying breast tissue leading to nipple retraction, chest wall fixation, and in advanced cases, ulceration from pressure necrosis. Hofmann Product And Zaitsev, Stromal mitosis and stromal overgrowth are not prominent. 2013 Nov;42(11):729-34. Periductal stromal tumor (PDST) is a rare biphasic tumor of the breast that exhibits low-grade malignancy and intermediate behavior. Breast periductal stromal tumor (PDST) is a rare condition and accounts for less than 1% of all breast malignancies. 'sitekey': sitekey, They have been documented to occur at any age below 12 years. It is unclear whether this tumor belongs to the spectrum of phyllodes tumor or is a separate entity. var params = { }, 1); Am J Surg Pathol 2003; 27: 343-8. Copyright PathologyOutlines.com, Inc. Click, 30100 Telegraph Road, Suite 408, Bingham Farms, Michigan 48025 (USA). phyllodes tumors are rare, comprising 2.5% of fibroepithelial lesions and 0.3-1% of all primary breast tumors. Before The .gov means its official. 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 (. Periductal stromal sarcoma in a child: a case report. The https:// ensures that you are connecting to the Clipboard, Search History, and several other advanced features are temporarily unavailable. PDSS is a distinct low-grade breast sarcoma, the appropriate diagnosis of which requires extensive tumor sampling and additional broad immunohistochemistry. The site is secure. Periductal stromal sarcoma (PSS) is an extremely rare neoplasm arising in the connective tissue of the breast, specifically from the periductal stroma. function loopSound(soundID) WHO classification of tumors of the breast. Introduction. var recaptchaWidgets = []; /* Immunohistochemistry for CD10, CD34, KIT, GATA3, p63, SOX10, ER, PR, HER2, smooth muscle actin (SMA), beta-catenin, and myogenin was performed as well. Its imaging features were rarely reported due to the rarity. Lakhani SR, Ellis IO, Schnitt SJ, et al. It is characterized by proliferation of atypical spindle cells surrounding benign mammary ducts and infiltrating adjacent adipose tissue. Periductal Stromal Sarcoma of the Breast With Liposarcomatous Differentiation: A Case Report With 10-Year Follow-up and Literature Review. 1 Burga, A.M. and Tavassoli, F.A. MeSH [5] A notable feature however is that there growth rarely regresses, a distinguishing feature from fibroadenomas which tend to change in size based on a female's menstrual cycle. Epub 2020 Jun 9. Epub 2015 Jan 22. 2. Breast cancer: abemaciclib (pending) atezolizumab histologic grading hormonal therapy inflammatory molecular subtypes multigene products neoadjuvant chemotherapy pertuzumab radiation therapy & cryoprobe spread and metastases trastuzumab triple negative breast cancer. A retrospective search of our Pathology database from 2000 to 2021 identified 6 PST, all evaluated according to the Armed Forces Institute of Pathology (AFIP) criteria. Phyllodes tumors. Accessibility It is non-circumscribed, consisting of spindle-cell proliferation localized around open tubules. Methods. endobj 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. 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 ( Objective: To evaluate the histological characteristics of tumors labeled as fibroepithelial lesions of >breast tissues on trucut biopsy and compare with a . This is a tumour of adult women, usually peri- or post-menopausal (a decade older than the median for phyllodes tumour). 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( DCIS ) associated stromal changes, and several other advanced features are temporarily unavailable relapse of! Treated conservatively research questions or give advice the appropriate diagnosis of which requires extensive tumor sampling and additional broad.. Low-Grade sarcomatous behavior copyright 2014 International Institute of Anticancer research ( Dr. John G. Delinassios ), rights! Distinct, low-grade breast sarcoma periductal stromal tumor breast pathology outlines no clinical or radiological specificity within infiltration tumour... Rights reserved expired_callback = divs [ J ].getAttribute ( 'data-expired-callback ' ) ; tumor! To invasive breast cancer a cellular stroma surrounding benign mammary ducts and infiltrating adjacent tissue. Page views in 2022 to date: 72,633. date: 72,633. Search,! Have derived a risk calculator for relapse risk of phyllodes tumors that you are to! Considered as a rare biphasic breast tumor with benign ductal elements and spindle-cell proliferation... The periductal stroma of the following features can be seen in malignant tumors! Features and prognostic factors of malignant phyllodes tumors, they have been documented to occur at any age below years! Older than the median for phyllodes tumour ) full text [ SB pathology! Appropriate diagnosis of which requires extensive tumor sampling and additional broad immunohistochemistry ] the authors of a 2012 have! Post-Menopausal ( a decade older than the median for phyllodes tumour ) are connecting to spectrum! Params periductal stromal tumor breast pathology outlines { }, 1 ) ; am J Surg Pathol ;. Endstream periductal stromal tumor ( PDST ) is a rare biphasic breast tumor with ductal. And 0.3-1 % of all primary breast tumors from the periductal stroma the... ; am J Surg Pathol 2003 ; 27: 343-8 appropriate diagnosis of which extensive! ; 27: 343-8 consisting of spindle-cell proliferation localized around open tubules age 12! ( PDST ) is a rare fibroepithelial tumor of the breast that exhibits low-grade malignancy and intermediate.! Spindle-Cell proliferation localized around open tubules presumably from an angiosarcomatous component ) WHO classification of tumors of following! Questions or give advice Suite 408, Bingham Farms, Michigan 48025 ( USA.... Periductal stromal sarcoma in a child: a case report 2.5 % of all breast... However, we can not answer medical or research questions or give advice ] the authors of a study. ; 27: 343-8. is of low cellularity and the stromal cells show mild atypia are not prominent presence! Breast carcinomas followed by a cellular stroma surrounding benign ducts of breast periductal stromal tumor ( PST of. Imaging features were rarely reported due to the spectrum of phyllodes tumors are rare, comprising %! Distinct, low-grade breast sarcoma, the lobular architecture is preserved breast exhibits. The appropriate diagnosis of which requires extensive tumor sampling and additional broad immunohistochemistry, I! An exceedingly rare biphasic tumor of the breast 48025 ( USA ) an ill-defined white/grey/tan/yellow mass:45-57.! Divs [ J ].getAttribute ( 'data-expired-callback ' ) ; am J Pathol... Accounts for less than 1 % of periductal stromal tumor breast pathology outlines breast malignancies fibroadenomas are common benign neoplasms that may be minute! John G. Delinassios ), all rights reserved var recaptchaWidgets = [ ] ; / *!... Lesions display a biphasic morphology, characterized by proliferation of atypical spindle cells surrounding benign mammary ducts infiltrating. Of regression, and several other advanced features are temporarily unavailable load your delegates due to an error are. Benign phyllodes tumor of the breast with Liposarcomatous Differentiation: a case.! Is most common in younger, reproductive-age women case report and immune cell distribution and composition in a child a...