Martínez, R. M. Alejandra; Hardisson, H. David; Muñoz, M. Mar; Gómez, P. Francisco; de Santiago, G. Javier
August 2008
Revista Chilena de Obstetricia y Ginecología;2008, Vol. 73 Issue 4, p273
Academic Journal
Phyllodes tumor (TP) is a rare tumor. The majority of them have been described as benign, with the reminder divided between borderline and malignant tumors. Case description: 47-year-old patient derived to our hospital to evaluate a recurrent TP after three local failures. Surgical removal of tumor had positive margins in the previous surgeries. She presented to our service with a nodule in the scar that was resected. The pathology diagnosis revealed a poor differentiated osteosarcoma. As surgical margins were close, the treatment was completed with a wide local reexcision and adequate surgical margins plus chemotherapy. Multiple pulmonary nodules compatible with metastasis were targeted in the thoracic TC during follow-up and another chemotherapy scheme was initiated. The patient did not respond and died due to the progression of her pulmonary disease. Discussion: Surgical removal is the mainstay of TP treatment and wide excision with adequate margins superior to 1-2 cm remains the treatment of choice. Lymphatic spread is uncommon and axillary metastases occur in less than 5-10% of patients, and therefore routine axillary dissection is not necessary. Conclusion: An incomplete resection in a malignant TP favours stromal overgrowth and sarcomatous transformation, which has very poor prognostic features.


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