Malignant Phyllodes Tumor of the Right Breast with Sacral Bone Metastasis- A Clinical Case from our Practice with A Literature Review

L. Marinova, N. Kahchiev, V. Vasileva
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Abstract

Phyllodes breast neoplasms are rarely diagnosed biphasic tumors that are benign, borderline, or malignant. We present a rare malignant phyllodes tumor in a 62-year-old woman with bone metastasis in the sacrum, presented 4 months after radical breast tumor surgery. Because of a severe pain syndrome, we performed intensity modulated radiotherapy with a high single dose of 8 Gy in two fractions, once a week. In this article we emphasize the difficult histopathological diagnosis, as well as the differential diagnosis, requiring immunohistochemistry of the two tumor components / epithelial and stromal/, as well as the clinical and pathological characteristics determining the malignant nature of the disease. In the presence of a soft tissue component of the bone metastasis, a biopsy with immunohistochemistry is required to prove the histopathological diagnosis of the distant metastasis. Distant metastases require complex treatment, including chemotherapy and palliative radiation therapy
右侧乳腺恶性皮样瘤伴骶骨转移--临床病例及文献综述
乳腺梭形细胞瘤是一种很少诊断的双相肿瘤,有良性、边缘性或恶性之分。我们报告了一名 62 岁女性的罕见恶性蝶形花瘤,患者在乳腺肿瘤根治术后 4 个月出现骶骨骨转移。由于严重的疼痛综合征,我们对患者进行了强度调节放疗,单次剂量为 8 Gy,每周一次,分两次进行。在这篇文章中,我们强调了组织病理学诊断的困难性,以及鉴别诊断,这需要对两种肿瘤成分(上皮和基质)进行免疫组化,以及确定疾病恶性的临床和病理特征。如果骨转移瘤中存在软组织成分,则需要进行活检并进行免疫组化,以证明远处转移瘤的组织病理学诊断。远处转移需要复杂的治疗,包括化疗和姑息性放疗。
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