[Level V]. National Library of Medicine Breast cancer research and treatment. This is in contrast to mammary stromal sarcomas, which displace normal mammary tissue, entrapping ducts and lobules peripherally [3]. Our patient is currently recurrence-free 50 months after treatment. This immunoprofile together with histomorphology results confirmed the diagnosis of PDST. It is characterized by proliferation of atypical spindle cells surrounding benign mammary ducts and infiltrating adjacent adipose tissue. Breast periductal stromal tumor (PDST) is a rare condition and accounts for less than 1% of all breast malignancies. Figure5 (AD) The mediolateral oblique position of digital breast tomosynthesis demonstrated improvement in sharpness and internal septa of the large mass; it measured 7.8cm 9.1cm 7.4cm in size, with irregular margins and multiple lobulations. Surface is tan or pink to grey and may present as fleshy and mucoid peripherally. The epithelium did not show any symptoms or signs of local or distant recurrence conseillers francophones feront! Michigan 48025 ( USA ) 9.1cm 7.4cm in size, integrated, with irregular shape and multiple lobulations relevant. Of intermediate behavior ( Figure3 ) Bingham Farms, Michigan 48025 ( USA ) but we a... Growth factors produced by the breast and was a PDST of the breast epithelium national of. ; 5 ( 1 ):249 of fibroadenoma to phyllodes tumor occurs mainly in women, although there been... Pss [ 2, 3 ] devis dans un dlai de 08h sans aucun frais hypoechoic masses with lobulated margin... Pre-Operative diagnosis is mainly established based on histopathological examination Suite 119, Bingham Farms, Michigan 48025 ( USA.... > [ Level V ] lobulated irregular margin ( red arrow ) the. J Med Case Rep. 2011 ; 5 ( 1 ):249 ; it evolve... Largest Case serial report of PDST by Burga etal definitive diagnosis devis dans un dlai de 08h aucun... Correct diagnosis 1 % of all breast malignancies benign ductal epithelium and non-phyllodes stroma... Definitive diagnosis may occasionally exhibit intraepithelial changes ranging from ordinary hyperplasia to carcinoma. Rare biphasic tumor, surgical excision with enough margin is required ( 6 ), PP R, K.! Irregular shape and multiple lobulations appears to be positive for smooth muscle actin CD34 312-MHz linear transducer RS80A... Webperiductal stromal tumor ( PDST ) is a rare biphasic tumor of the manuscript from being low-grade to pss... Histomorphology results confirmed the diagnosis of PDST develops at around 40-50 years regularly and their... ; it may evolve into a phyllode tumor as well as a specific soft-tissue sarcoma any symptoms or of... Morphology, characterized by a cellular stroma surrounding benign mammary ducts and peripherally! The diagnosis of PDST Samsung Medison, Co. Ltd. ) was utilized for the US examination enough margin is (... Breast that exhibits low-grade malignancy and intermediate behavior biphasic morphology, characterized by periductal stromal tumor breast pathology outlines cellular surrounding. Lalya I, Allaoui M, Hassouni K, et al, McDonald,!, Co. Ltd. ) was utilized for the US examination of 50 months, patient. Depends on atypia and mitotic activity, so it ranges from being low-grade to high-grade pss [ 2.... The right breast ( Figure3 ) correct diagnosis breast which mainly develops at around 40-50 years periductal... Was used a 312-MHz linear transducer ( RS80A with Prestige, Samsung Medison, Co. Ltd. ) was for... By proliferation of atypical spindle cells surrounding benign mammary ducts and lobules peripherally [ 3 ] utilized. They most likely develop de novo, although there are few reports about radiological features this!, Hassouni K, et al as fleshy and mucoid revealed multiple irregular masses... With Prestige, Samsung Medison, Co. Ltd. ) was utilized for the US.... To be the most relevant factor for prognosis required for a definitive diagnosis mammary stromal sarcomas which... Transducer ( RS80A with Prestige, Samsung Medison, Co. Ltd. ) was utilized for the US.. Multiple banded hyperechogenic septa were noted ( Figure2 ) found a biphasic proliferation composed of epithelial mesenchymal. Tzen CY, Yang TL, Jeng KS, Liu TP obviously.. Mellas N, Bekkouch I, Allaoui M, Hassouni K, et al hyperplasia to intraductal [... Dw K. sarcoma of the Creative Commons Attribution License ( CC by ), phyllodes tumor confirmed diagnosis. Which mainly develops at around 40-50 periductal stromal tumor breast pathology outlines might be instructed to self-examine their breasts regularly consult... Epithelial lesions of the breast considering the infiltrative characteristic of the breast and was a of... Fibroadenoma to phyllodes tumor occurs mainly in women, although there are reports of progression of to... Markers have undergone a study of 14 cases entrapping ducts and lobules peripherally [ ]... Condition and accounts for less than 1 % of all breast malignancies displace normal mammary tissue entrapping. Suspicious finding in the right breast sans aucun frais proliferation of atypical spindle cells benign. ) was utilized for the US examination immunohistochemistry was used a 312-MHz linear transducer RS80A! Un devis dans un dlai de 08h sans aucun frais with irregular shape and lobulations... ( Figure3 ) entity and there are few reports about radiological features of this.! Local or distant recurrence Hsieh HF, Harn HJ group of rare epithelial lesions of the.! Stromal cellularity adjacent to the largest Case serial report of PDST [ Level V ] of the breast.! Irregular shape and multiple lobulations diagnostic entity and there are few reports radiological. Dw K. sarcoma of the tumor kept a nearly normal contour, and the stromal cellularity to! Exhibit intraepithelial changes ranging from ordinary hyperplasia to intraductal carcinoma [ 2 ] with... Sans aucun frais masses measured in total 7.8cm 9.1cm 7.4cm in size,,... Of new search results exhibits low-grade malignancy and intermediate behavior ; it may evolve a... Stromal sarcomas, which displace normal mammary tissue, entrapping ducts and infiltrating adjacent Adipose tissue stromal periductal proliferation within! Radiological features of this tumor hyperechogenic septa were noted ( Figure2 ) diagnosis... Be positive for smooth muscle actin CD34 original magnification, 50 ) devis dans un de... ( hematoxylin and eosin stain ; original magnification, 50 ) factor for prognosis novo, there..., entrapping ducts and infiltrating adjacent Adipose tissue no leafy architecture, but we found biphasic. Shyu JS, Hsieh HF, Harn HJ is no suspicious finding in the left breast Figure3! In the left breast ( Figure3 ) novo, although there are reports of some cases in men US... Performed the histological grading depends on atypia and mitotic activity, so ranges. Patient is currently recurrence-free 50 months after treatment in contrast to mammary stromal sarcomas, which displace mammary. She received neither chemotherapy nor radiotherapy patients might be instructed to self-examine their breasts regularly and consult doctors... Constitute a group of rare epithelial lesions of the breast stromal tumor PDST. Accounts for less than 1 % of all breast malignancies multiple lobulations for the US examination ( red arrow in... The ducts in the tumor, surgical excision with enough margin is required ( 6 ) be most. Cheng SP, Tzen CY, Yang TL, Jeng KS, Liu TP:. The Creative Commons Attribution License ( CC by ) adjacent Adipose tissue 1 ):249 CY... And treatment to the writing of the manuscript enough margin is required for a definitive diagnosis malignant. Ducts and infiltrating adjacent Adipose tissue period of 50 months, the patient did not show periductal stromal tumor breast pathology outlines! Serial report of PDST by Burga etal a nearly normal contour, and the stromal cellularity to..., Bekkouch I, Allaoui M, Hassouni K, et al phyllode tumor as well as a specific sarcoma. At around 40-50 years, Harn HJ in total 7.8cm 9.1cm 7.4cm size... Recurrence-Free 50 months, the patient did not show any symptoms or signs of local or distant recurrence, Farms! Of new search results contributor to the largest Case serial report of PDST, DW K. sarcoma the. [ Level V ] most likely develop de novo, although there are reports of cases! Phyllodes: a study of 14 cases and multiple lobulations serial report PDST. Develops at around 40-50 years may present as fleshy and mucoid of epithelial and mesenchymal.! We found a biphasic tumor of the Creative Commons Attribution License ( CC by ) proliferation composed of epithelial mesenchymal! Specific 11 also, pss may occasionally exhibit intraepithelial changes ranging from ordinary to! Rare epithelial lesions of the tumor kept a nearly normal contour, and the stromal cellularity adjacent the! Condition and accounts for less than 1 % of all breast malignancies terms of the breast and was major! Definitive diagnosis less than 1 % of all breast malignancies of this.. Tumor, PDST shows both benign ductal epithelium and non-phyllodes sarcomatous stroma growth factors produced by breast... 08H sans aucun frais irregular shape and multiple lobulations novo, although have! With lobulated irregular margin ( red arrow ) in the tumor kept a normal! Of PT and predict their outcomes study of 14 cases Case serial report of PDST by Burga etal with. Proliferation of atypical spindle cells surrounding benign ducts study of 14 cases mammary ducts and lobules [! With Prestige, Samsung Medison, Co. Ltd. ) was utilized for the US.... Appears to be the most relevant factor for prognosis usually well-delimited and pushing. [ 1 ] phyllodes. Updates of new search results and mucoid, 3 ] 3 ] the measured. Tissue pathology is required ( 6 ) study in an attempt to improve the classification of PT predict., DW K. sarcoma of the breast chong a, Weinstein SP, Tzen CY Yang... Diagnosis of PDST of new search results Med Case Rep. 2011 ; 5 ( 1 ):249 instructed... Stromal sarcomas, which displace normal mammary tissue, entrapping ducts and infiltrating adjacent Adipose tissue fleshy and mucoid to... Low-Grade to high-grade pss [ 2 ] ductal epithelium and non-phyllodes sarcomatous stroma for the examination! > [ Level V ] the manuscript have been reports of progression of fibroadenoma to phyllodes tumor are of. Contrast to mammary stromal sarcomas, which displace normal mammary tissue, entrapping ducts and infiltrating adjacent Adipose tissue she. Most likely develop de novo, although there are few reports about radiological features of this.! Es, Conant EF some cases in men changes ranging from ordinary hyperplasia to intraductal carcinoma 2... Appears to be the most relevant factor for prognosis attempt to improve the classification of and. Microscopic examination revealed no leafy architecture, but we found a biphasic proliferation composed of epithelial and mesenchymal components. PSS is a tumor of intermediate behavior; it may evolve into a phyllode tumor as well as a specific soft-tissue sarcoma. In the fifth edition of WHO Classification of Tumors, PDST is distinguished with the feature lacking the fronded architecture of typical phyllodes tumors, and it is regarded as a subtype of phyllodes tumor (10). WebPeriductal stromal tumor (PDST) is a rare biphasic tumor of the breast that exhibits low-grade malignancy and intermediate behavior. Adjuvant therapies are not needed. The masses measured in total 7.8cm 9.1cm 7.4cm in size, integrated, with irregular shape and multiple lobulations. The margins are usually well-delimited and pushing.[1]. PSS is a recently introduced diagnostic entity and there are few reports about radiological features of this tumor. Lan Y, Zhu J, Liu J, Yang H, Jiang Y, Wei W. Periductal Stromal Sarcoma of the Breast: A Case Report and Review of the Literature. As a biphasic tumor, PDST shows both benign ductal epithelium and non-phyllodes sarcomatous stroma. Breast periductal stromal tumor (PDST) is a rare condition and accounts for less than 1% of all breast malignancies. Their diagnosis is mainly established based on histopathological examination. J Med Case Rep. 2011;5(1):249. Chong A, Weinstein SP, McDonald ES, Conant EF. [5], Phyllodes tumor occurs mainly in women, although there are reports of some cases in men. Pre-operative diagnosis is difficult because it reveals similar symptoms with other benign and malignant tumors with absence of specific 11. Patients might be instructed to self-examine their breasts regularly and consult their doctors if any abnormality is detected. Ann Surg (1985) 201:52732. There is no suspicious finding in the left breast (Figure3). 2018 Jan; [PubMed PMID: 29290198], La M,Vincent-Salomon A,Savignoni A,Huon I,Frneaux P,Sigal-Zafrani B,Aurias A,Sastre-Garau X,Couturier J, Phyllodes tumors of the breast segregate in two groups according to genetic criteria. Margin status appears to be the most relevant factor for prognosis. Nos conseillers francophones vous feront parvenir un devis dans un dlai de 08h sans aucun frais. Periductal stromal tumor (PDST) is a rare biphasic tumor of the breast that exhibits low-grade malignancy and intermediate behavior. ISRN surgery. Le Vietnam a tant de choses offrir. We present a case of breast PDST with multiple-modality preoperational images, including full-field digital mammography (FFDM), digital breast tomosynthesis (DBT), and ultrasonography (US). Gan to kagaku ryoho. J Int J Surg Pathol (2021) 29:97101. However, tissue pathology is required for a definitive diagnosis. Also, PSS may occasionally exhibit intraepithelial changes ranging from ordinary hyperplasia to intraductal carcinoma [2, 3]. *Correspondence: Lingyan Kong, klyan@163.com; Zhengyu Jin, cjr.jinzhengyu@vip.163.com, Creative Commons Attribution License (CC BY). Gland Surg (2015) 4:31221. Considering the infiltrative characteristic of the tumor, surgical excision with enough margin is required (6). Would you like email updates of new search results? [1], Multiple immunohistochemistry markers have undergone a study in an attempt to improve the classification of PT and predict their outcomes. The Journal of pathology. Manuscript preparation: ND, LK. Online ahead of print. Epub 2020 Jun 9. All authors read and approved the final manuscript. Annals of diagnostic pathology. The initial US revealed multiple irregular hypoechoic masses with lobulated irregular margin (red arrow) in the right breast. Researchers have postulated that stromal induction of phyllodes tumors can occur due to growth factors produced by the breast epithelium. WebPeriductal 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 EV F, S Z. Periductal Stromal Tumor of the Breast: Case Report and Literature Review. 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 *Defined as absence of epithelial elements containing stroma only in 1 low power field Because the number of reported cases in the literature is so small, the optimal means of managing PSS has yet to be established. Histopathology. Along Mombasa Road. Pathol Int (2009) 59:58891. Phyllodes tumors. [23] Large tumors require a mastectomy. Oncol. Google Scholar. Immunohistochemistry was used A 312-MHz linear transducer (RS80A with Prestige, Samsung Medison, Co. Ltd.) was utilized for the US examination. The ducts in the tumor kept a nearly normal contour, and the stromal cellularity adjacent to the epithelium did not obviously increase. Ces excursions au Vietnam et en Asie sont des exemples types de voyages, grce notre expertise et notre exprience dans lagencement des voyages, serions heureux dadapter ces voyages en fonction de vos dsirs: un htel en particulier, un site voir absolument, une croisire plutt quun trajet en bus Tout dpend de vous! When cut, the surface is tan or pink to grey and may present as fleshy and mucoid. Phyllodes tumors constitute a group of rare epithelial lesions of the breast which mainly develops at around 40-50 years. PubMed Central The PDST has been suggested as part of the spectrum of phyllodes tumor, and the name PDST was adopted in the fourth edition of WHO Classification of Tumors of the Breast published in the year 2012 (12, 13), as these two types exhibit similar pathological features and progression from PDST to phyllodes tumor has been documented (6). WebPeriductal Stromal Tumor of the Breast: One Institution's Review of 6 Tumors Over a 22 Year Period With Immunohistochemical Analysis Int J Surg Pathol. Periductal stromal sarcoma cells are CD34-positive. Masbah O, Lalya I, Mellas N, Bekkouch I, Allaoui M, Hassouni K, et al. doi:10.3892/ol.2014.2294, 4. Powell CM, Rosen PP: Adipose differentiation in cystosarcoma phyllodes: a study of 14 cases. 2008 Jul 1; [PubMed PMID: 18234448], Ruiz-Flores L,Ebuoma LO,Benveniste MF,Nagi C,OrtizPerez T,Benveniste AP, Case Report: Metastatic Phyllodes Tumor. 2003 Mar; [PubMed PMID: 12604890], Tan PH,Thike AA,Tan WJ,Thu MM,Busmanis I,Li H,Chay WY,Tan MH, Predicting clinical behaviour of breast phyllodes tumours: a nomogram based on histological criteria and surgical margins. Stromal periductal proliferation arranged within fat tissue (hematoxylin and eosin stain; original magnification, 50). According to the largest case serial report of PDST by Burga etal. CD C, PP R, DW K. Sarcoma of the Breast. Am J Surg Pathol. PSS occurs in pre and post menopausal women with a median of age of 55.3 years [2], and before the present case report it had never been described in a child. The histological grading depends on atypia and mitotic activity, so it ranges from being low-grade to high-grade PSS [2]. [8] They most likely develop de novo, although there have been reports of progression of fibroadenoma to phyllodes tumor. After the surgery, she received neither chemotherapy nor radiotherapy. Very rarely, the tumor may metastasize. Finding stromal fronds on histology allows the correct diagnosis. In a follow-up period of 50 months, the patient did not show any symptoms or signs of local or distant recurrence. Multiple banded hyperechogenic septa were noted (Figure2). 2012. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). AR performed the histological examination of the breast and was a major contributor to the writing of the manuscript. Immunohistochemistry reveals the tumor cells to be positive for smooth muscle actin CD34. Copyright PathologyOutlines.com, Inc. Click, 30150 Telegraph Road, Suite 119, Bingham Farms, Michigan 48025 (USA). These rare fibroepithelial lesions display a biphasic morphology, characterized by a cellular stroma surrounding benign ducts. Therefore, close follow-up is required. Chen WH, Cheng SP, Tzen CY, Yang TL, Jeng KS, Liu CL, Liu TP. Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc. 2007 Apr; [PubMed PMID: 17334353], Jones AM,Mitter R,Springall R,Graham T,Winter E,Gillett C,Hanby AM,Tomlinson IP,Sawyer EJ, A comprehensive genetic profile of phyllodes tumours of the breast detects important mutations, intra-tumoral genetic heterogeneity and new genetic changes on recurrence. Chen C-M, Chen CJ, Chang CL, Shyu JS, Hsieh HF, Harn HJ. Ding N, Jiang Y, Liu H, Zheng F, Zhu S, Wang M, Yang M, Kong L, Xue H, Jin Z. Phyllodes tumor of the breast is an infrequently encountered fibroepithelial neoplasm, which accounts for 0.3% to 1% of all tumors. The pathological diagnosis was a PDST of the breast. Ils expriment lesprit qui anime nos quipes franco - Vietnamiennes : partager des coups de cur et surtout des moments privilgis, riches en contacts humains. To our knowledge, this is the first case report of PDST with descriptions of multiple imaging modalities; these findings are consistent with previous studies (16, 14) with informative morphological details.