Se encontró adentro – Página 300excluirse carcinoma de la mama masculina. ... Tumor filoides. ... Surgen de las células del estroma en la mama y se clasifican como de grado bajo, ... La investigación, que es uno de los principales motores del desarrollo de un país, solo tiene éxito cuando se hace adecuadamente, es decir, cuando prosigue los pasos del Método Científico, ya que si sigue un camino confundido no ... Ann Surg Oncol. All 40 patients were female, with a mean age of 41 years. Kurt A, Tallidede S, Sace C, Bas L, Karankel H. A giant cystosarcoma Phyllodes. Four patients were treated with ifosfamide (alone in three and combined with doxorubicin in one). Several histological parameters should be evaluated, including stromal cellularity, atypia, mitoses, stromal overgrowth, infiltrative borders, and presence or absence of necrosis. 13). Occasional patients have extremely aggressive disease that may result in death. Tumour size and surgical margins were found to be the principal determinants of LR and DM. "CD34, CD117, and actin expression in phyllodes tumor of the breast". y englobadas dentro de las de bajo grado (2). Femenino de 11 años de edad Antecedente de meduloblastoma a la edad de 1 año, resecado y tratado con quimioterapia Noviembre de 2019 con tumor de mama diagnosticado como: tumor Phyllodes de bajo grado Noviembre 2019 y enero de 2020 con tumor frontal extraaxial 0000004422 00000 n
Aspirates from malignant PT were very cellular, with a high stromal/epithelial ratio and marked stromal cellularity. 18/28 malignant cases recurred, and 17 patients (2 borderline and 15 malignant) died. Mayor incidencia en mujeres latinas. Increased copy number of 1q material in the phyllodes tumors studied, in one case restricted to 1q24-32, was associated with recurrence (P = 0.00365) and might therefore be considered as an indicator of local aggressiveness requiring more radical treatment. H�\�]k�0�{Źl/�5["m��}0��ɱf�^���PyH���IXTe����w;ʚg�z�,O��J�����T/��[� BW\/��C��1�2 Wide local excision or mastectomy in 18 patients was followed by four recurrences (one of eight borderline tumours, three of ten malignant tumours). laminillas, con informe de tumor filoideo de bajo grado con componente estromal fusocelular y adiposo, componente adiposo en 60% de la superficie tumoral, Radical, modified-radical, and simple mastectomy and tumorectomy are typical treatments; therapeutic results are the same for each treatment modality. Phyllodes tumor metastasizing to the small bowel is extremely rare, with only three known previously described case reports in the literature. whereas an Auchincloss modified radical mastectomy or a total glandectomy with lymph node dissection is recommended for patients (9����b|�{!ߢ�h���k��-!���.AMj��«�d�ZCy��i�*>׀Pe.�3�����Q�E�3E#Й�V���Vq�>�TMO�d��J�#S�tbzd:3��.L�H��+� ��}
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believe that excision with sufficient free margin may be the treatment of choice for most benign or borderline phyllodes tumors, Cystosarcoma Phyllodes tumors in men. . Se encontró adentro – Página 118cópica a este tumor , a las que Müller designó Phyllodes y , en consecuencia al tumor , cystosarcoma phyllodes . El carácter y grado de malignidad del ... Clinical data analyzed included age, presenting symptoms and signs, tumor size, location, type of surgery, time to recurrence, and metastasis. The right side of the neck was, To study the relationship between pathological features and classification criteria of the breast Phyllodes tumor. Presentamos dos casos de dos pacientes de 33 y 38 años, respectivamente, diagnosticadas de tumor filodes de la mama y tratadas en nuestro servicio. Cystosarcoma phyllodes is a rare malignancy of the female breast. Local recurrence of any grade was usually followed by further recurrence. 3. The role of adjuvant radiotherapy and chemotherapy remains to be defined. 0000031074 00000 n
Chemotherapy is based on guidelines for the treatment of sarcomas, not breast adenocarcinoma. Re-examining the pathology material we found 84 cases, while thirteen more cases which had been initially classified as fibroadenomas with areas of phyllodes tumor were rejected from the analysis because they were classified as fibroadenomas. Twenty-five patients received postoperative radiotherapy, and 2 received chemotherapy in addition. El grado 1 se describe como un tumor de bajo grado con una buena diferenciación de las células tumorales. Tumor filoide de la vesı ́cula seminal: caso clı ́nico y revisio ́n de la literatura Phyllodes tumour of the seminal vesicle: case report and revision of literature Sr. Director: Le presentamos el caso de un hombre con 64 an ̃os, asintoma ́tico, con masa supraprosta ́tica diagnosticada en ultrasonido transrectal. Figura 3: liposarcoma mixoide en conjunción con tumor phyllodes de la mama. ?��4ۅ6'5��
�7����J����RXߌ���L�9)�^��L�/�U����s5+>Ôx�#Gœi$�F_9�"7r�.n�k�o>�P�v���$v��'�W��WCJ�'H@�:B��*�3TB��%"�!�@2��(��r Se encontró adentro – Página 38Histopatológicamente se comprende aún mejor su nombre de Phyllodes o filiáceo ... de hoja del tejido tumoral dentro de las cavidades quísticas del tumor . BIBLIOGRAFÍA. Se encontró adentro – Página 589... 13 B. Benignos 50 C. De bajo grado de malignidad 10 desde el año de 1946 a 1966. ... En esta revisión se encontró un total de tumores mamarios entre ... The average annual age-adjusted incidence rate of malignant cystosarcoma phyllodes is 2.1 per 1 million women. The majority of tumors were found in the upper outer quadrant (46.0%), with an equal propensity to occur in either breast (48.8% vs. 50.0%). Se encontró adentro – Página 221... para la cirugía de rescate en el carcinoma de mama y los tumores filodes. Esta mujer de 35 años ha sido intervenida de un tumor filodes de bajo grado en ... Applying the criteria of Azzopardi and Salvadori, each case of PT can be managed successfully avoiding unnecessary mastectomies. Older patients and patients with larger tumors had a higher probability of local recurrence. Postgrad Med J. Data from 38 patients with a phyllodes breast tumour were reviewed retrospectively, reclassifying the pathological material using the Pietruszka and Barnes criteria. En relación al tratamiento la cirugía es el tratamiento de elección del tumor phyllodes, siendo el tipo de mastectomía motivo de controversia, debido a que existen tumores que pueden ser tratados mediante una cirugía conservadora de la mama(1,3,7). In 81% (46 of 57 PTs), good cytohistologic correlation (32 benign, 8 borderline and 6 malignant) was observed. 0000028268 00000 n
Patient, disease, and treatment factors were compared using log-rank test. However, patients with tumor size more than 5 cm (hazard ratio 2.9) were found to have increased hazard, whereas those receiving adjuvant radiotherapy (hazard ratio 0.6), married women (hazard ratio 0.4), and those women over the age of 35 years (hazard ratio 0.7) showed a decreased hazards. 0000005915 00000 n
con celularidad estromal alta, áreas de necrosis y hemorragia. �!o�[�6�g�G�_����\�=ك�,`%+��� ~$?����������ω���\a� W�+�� Lymph node metastases are unusual and occur secondary to necrotic tumor. With wide excision the recurrence of the tumor decreased suggesting that broad excision is preferred for the benign phyllodes tumor and mastectomy is indicated for recurred borderline and malignant tumors. Local recurrence was found in 14 patients (8.2%) (4 benign, 3 borderline, and 7 malignant); 10 of these underwent reoperation (7 wide local excision, 3 radical mastectomy) and survived 5 years NED. Histopathologic examination of the 8 tumors showed benign cystosarcoma phylloides in 5, recurrent benign tumor in 1, coexistent invasive papillary carcinoma in 1, and coexistent in situ duct cancer and in situ lobular cancer in 1. total of one hundred and sixty-six lymph nodes were sampled during axillary dissection. In 18 patients only 50% were positively identified as having phyllode tumors. El Marqués Avenida Sanz Edificio Tocuyero Caracas, Venezuela. progesterone receptor (PgR) status was positive in nine (75%) of 12 cases. The authors retrospectively studied 45 histologically proven fibroepithelial breast tumors of which 33 were FA and 12 were PT (1 malignant, 8 borderline, and 3 benign) to define cytologic features that can help in the accurate categorization of these lesions by using FNA samples. There were occasional, if any, single stromal cells. 05). The treatment of these tumors is surgery, however the extent of surgery, the application of adjuvant chemotherapy and radiotherapy are still controversial. Se estableció el diagnóstico de tumor filodes de bajo grado (benigno). According to histology, the series was divided into three groups, of 28 (34.5%) benign tumors, 32 (39.5%) border-line tumors, and 21 (25.9%) malignant tumors. Conclusión: x�b```�� RV�A��bl,w���:ܜ���ni( f"05��d����p]��I�T���;,�y��g��w�*�D���xf �ߔ9OF���M�T�g� 1��:` ,�(�� &X��H�T �f`*�l��,"��˗!ڰA&��u�&�́g삊���Ej]��=��!�0(�T��X̱��Q� �H�M��jM�W�'��xĘ�r2�`g�f�W����������q�
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r���\a� W�+�� p53 expression was associated with tumour grade (P = 0.001), prominent stromal overgrowth (P = 0.0003), prominent stromal nuclear pleomorphism (P = 0.006), high stromal mitotic count (P = 0.05), and an infiltrative tumour margin (P = 0. H����n�0��y�9n�zƞ�U���"A#8�++��D%����q��i��;��o������� �D���(߄����H�ǡ���Dq�����^=T�%j� H�\�An�@E�������UI,!K�H^L2g��� �
j�o?��QF$�AS�GQy���B?��WڽM�؇.�e�����N}Ȗ���v��������o��λp��r��x�����膃�g�[�,�������{����ig�+�z�:;��l���l.���.���m�j�=�~͕���2���elZ�M8YVi[��%m��B�ߺ,;ۏ&fU���"�?���+� The margin of surgical excision was found to be the only independent prognostic factor (p = 0.003). 0000020784 00000 n
&&��L��/@w���×:���.����ׁ����ۛ�No��� ��U�"{����d^C �ջ�]�'�Q�W�pBJ9��Ŗ$l�8�P��(k���dݕN��{-�ޏ��p֠4Or�����?k�n�秵����Ղ�:���K������*I��[n�T�2ՉH�>�lK��r��z7��}����x��o���?٩�\�Ri��fU��߿�(� 0000002552 00000 n
Patients in these groups were compared in terms of age, menopausal status, tumor size and the number of mitosis within the tumor. PCR-based loss of heterozygosity analyses were performed with the following markers on Chromosome 3p: D3S1478 (3p21.2--21.3), D3S1289 (3p21.1--21.2), and D3S1295 (3p14.3--21.1). El resultado estético es excelente en cuanto a cobertura cutánea, simetría, po-sición del surco mamario, posición del complejo areo- Being biphasic tumors, immunoquantification was performed in the stroma and epithelium. Radiology 2000;216:197-205. . Of the 170 treated patients, 141 (82.9%) survived 5 years without evidence of disease. El reporte definitivo de patología fue un tumor phyllodes maligno de alto grado de 8 cm, límites negativos que superan los 2 cm y ganglios axilares negativos. 0000009861 00000 n
The median follow-up was 9 years (range 5 months-28 years). Definitive surgery consisted of either lumpectomy in seven patients or mastectomy in the other seven patients. Single stromal cells are also important morphologic criteria for subclassification. Aunque pueden aparecer a cualquier edad, la mayor parte afecta a mujeres en el sexto decenio de la vida, es decir, 10 a 20 años más tarde de la presentación promedio del fibroadenoma(1,2). No axillary lymph node metastases were found. Konstantakos AK, Graham DJ. pero no > 0.5 cm. This is illustrated in our series of 106 patients, in whom 71.7% were mistakenly operated on for fibroadenoma. Twenty-one tumors were highly cellular and 17 showed cytologic atypia. 2,3 Unlike fibroadenomas, phyllodes tumors have a high incidence of local recurrence after surgery and a potential for hematogenous metastases. �Cq���B��A�ò=�c+�a�����S�����! The proportion of individual long spindle nuclei (>30%) amid the dispersed stromal cells in the background is the most reliable discriminator between the two lesions. Incidence data were collected from 1972-1989 by the Cancer Surveillance Program, the population-based cancer registry for Los Angeles County. The median follow-up was 43 months (range 1–170 months). 0000036264 00000 n
Zhonghua bing li xue za zhi Chinese journal of pathology. histología corresponde a un tumor phyllodes de bajo grado. Smears were composed of different proportions of clusters of epithelial cells (68.2%), phyllodes fragments (31.8%), spindle cells within stromal tissue (31.8%), isolated spindle-shaped or round cells (45.5%), and bipolar naked nuclei (22.7%). 2. Mediante ultrasonido se clasificó el tumor como BIRADS IV. Caracteristicas histológicas: el tumor phyllodes es una neoplasia fibroepitelial mamaria con un componente epitelial benigno y un componente mesenquimal benigno o maligno. Técnicas en cirugía general: cirugía de la mama presenta los procedimientos habituales y avanzados de las principales subespecialidades de la cirugía general. The re-excision specimen was 8.5]6.5]3.0 cm. Para los tumores neuroendocrinos de pulmones y timo, se utilizan el índice mitótico y la necrosis como marcadores tumorales para la clasificación. }�?�k��:�@�G�;L0Xg"�~����:QV`�N7ʷ�T���:'�Z7xQ� ? CONTENIDO: Las distintas técnicas de mastectomía. Microscópicamente para confirmar el diagnóstico de tumor phyllodes es necesario la presencia de el componente epitelial y el estroma. 0000036691 00000 n
Phyllodes breast tumor. A total of 291 cases of phyllodes tumors collected from the literature were then reviewed, comparing the 97 adolescent cases with the 194 adult cases. Three more patients with malignant PT underwent wide local excision. Las lesiones recurrentes podrían ser controladas con una nueva escisión local o una mastectomía. Complete surgical excision, by mastectomy if necessary, is important in the primary surgical treatment of high-grade MPT. Antecedentes: El tumor phyllodes (TP) es un tumor poco común y aunque el 34,5-63,7% son benignos, el resto tienen un comportamiento borderline o maligno. The location of the lung tumors and the cervical metastases is recorded. We 2003;69(9):808-811. Clasificación TNM del cáncer de vejiga T -Tumor primario • TX No se puede evaluar el tumor primario • T0 Ausencia de datos de tumor primario • Ta Carcinoma papilar no invasor • Tis Carcinoma in situ: "tumor plano" • T1 El tumor invade el tejido conjuntivo subepitelial • T2 El tumor invade el músculo • T2a El tumor invade el músculo superficial (mitad interna) 3p deletions do not play a significant role in the development of these tumors. There were five tumour-related deaths (10% of patients). In summary, Ki-67 expression may assist in distinguishing benign from malignant PT in diagnostically difficult cases. Cystosarcoma phyllodes is a rare sarcoma of the breast. Cytological and histological findings of a rare case of a malignant phyllodes tumor (with liposarcomatous components) of the breast are presented. La evolución postquirúrgica fue adecuada, la paciente se alivia de los síntomas dolorosos, de la deformidad y la asimetría. Thirty-two patients were treated by local excision with or without reexcision and four patients by mastectomy. For histologically diagnosed malignant cystosarcoma, the relative 5-year survival rate is about 80%. El tumor phyllodes es un tumor bifásico infrecuente, constituido por elementos epiteliales y un estroma fusocelular denso, constituye 0,3 % a 0,9 % de las neoplasias de la mama en la mujer y el 2 % -3 % de todos los tumores fibroepiteliales mamarios(1), en el sexo masculino hay pocos casos descritos(4). El tumor pesó 2.150 grs. This study reviewed 26 women who had resection of a malignant cystosarcoma phyllodes. Antecedentes: El tumor phyllodes (TP) es un tumor poco común y aunque el 34,5-63,7% son benignos, el resto tienen un comportamiento borderline o maligno. H�\��j�0��~ Clinical presentations were palpable mass, 25; pain, 11; and ulceration, 2. The term "sarcoma" was initially used because of its fleshy appearance, a more modern term is Phyllodes tumor (PT). 0000005338 00000 n
2. Eleven benign cases survived 9 to 35 years. Reoperation would then be logical advice, as with one of our patients. These findings are discussed in relation to other published series in the literature. Therapy of cystosarcoma is not uniformly agreed upon. Metastases occur in 20% of malignant tumors, lungs, bones, liver and brain being the frequent sites of metastases. One patient developed metastatic disease after total mastectomy and died after chemotherapy. At a median of 12 months, nine patients had developed a local recurrence and four had died from metastases. Este es predominantemente un tumor de mujeres adultas, con muy pocos ejemplos reportados en adolescentes. Excisional biopsy revealed a phyllodes tumor with a microscopic positive margin. Similar rates were observed based on the presence or absence of stromal overgrowth. We assessed 23 tumours as histologically benign, four as borderline and five as malignant. These results indicate that HIF-1alpha expression is associated with diminished disease-free survival and may play an important role in stromal progression of breast phyllodes tumors. The mean follow-up, for the three groups, was 106 months for benign, 84 months for borderline, and 82 months for malignant tumors; in no case was radical surgery followed by local recurrence: of 51 women conservatively treated, 14 experienced local relapse, i.e., one of 24 women with benign, ten of 22 with borderline, and three of 8 with malignant lesions. One patient with 8 cm diameter malignant PT, who underwent mastectomy, passed away sixteen months later from widely spread metastases. S100 positivo. Cox's regression was used for multivariate analysis of the data. Ninety-eight patients (57.6%) were treated by wide local excision (79 benign, 15 borderline, and 4 malignant), 43 (25.3%) by simple mastectomy (13 benign, 4 borderline, and 26 malignant), and 29 (17.1%) by radical mastectomy (all malignant). Neither DNA content nor S-phase fraction correlated with outcome. The logistic and therapeutic issues related to use of frozen-section diagnosis are discussed. The median age was 26 years (17-59), and 30 patients were female. Among these 13 patients, 4 had at least one recurrence and the recurrence rate was higher for the group who underwent lumpectomy (43% compared with 28%). Tis (Paget) Enfermedad de Paget del pezón sin tumor La enfermedad de Paget asociada a tumor se clasifica de acuerdo al tamaño del tumor T1 Tumor < 2 cm. Los pacientes suelen presentarse con una masa firme y palpable. Survival was estimated using the Kaplan-Meier method. Local excision was utilized in 105 patients (88%) and radical BACKGROUND Frozen section was of limited value (41.6%). At a median follow-up of 26 months (range: 3 to 164 months), there have been three recurrences, two in patients with low-grade tumors and one in a patient with a high-grade lesion, who eventually died as a result of widespread metastases. Merece la pena destacar que la ausencia de atipia no es un signo seguro de benignidad, pues no es una característica constante de los phyllodes borderline o malignos. Two cases of a phyllodes tumor in adolescents are herein reported. Our patients included 59 women and one man ranging in age from 16 to 72 years. en su mayor dimensión T1b Tumor > 0.5 cm. Mammography and breast echo were not reliable for differentiating PTs from fibroadenomas (6.9% vs. 37.9% and 3.3% vs. 45%, respectively). •One (4%) benign phyllodes tumor which lacked stromal fragments and single stromal cells on FNAB smears. 0000036195 00000 n
However, there was no significant difference between these two subgroups in terms of distant metastasis-free survival or overall survival. One of the difficulties to reach an accurate cytological diagnosis for MPT is the frequent overwhelming of clearly malignant sarcomatous cell by the presence of largely predominant clusters of epithelial cell. El grado del tumor aumenta con la edad en el diagnstico. Proliferation was assessed by Ki67 immunostaining and mitotic counts. The nodes contained cancer in twenty-four patients who were studied to determine the origin and probable route of the spreading tumor. Cystosarcoma phyllodes constitutes only 0.3-0.9% of all breast tumors. The clinical and pathological features of phyllodes tumors of the breast were evaluated through a study of 118 cases: 110 A large tertiary care teaching hospital. Three patients had recurrent tumours. En los tumores de grado 1, las células tumorales y la organización del tejido del tumor tienen una apariencia cercana a la normal. In view of the absence of stromal CAIX expression in phyllodes tumors, stromal upregulation of HIF-1alpha most probably arises from hypoxia-independent pathways, with p53 inactivation as one possible cause. There was no palpable axillary, supraclavicular, or cervical adenopathy. malignos, basado en el número de mitosis, tipo de márgenes y grado de sobrecrecimiento estromal. Age, surgical approach, mitotic activity, and surgical margin were significantly correlated with recurrence (P = 0.029, 0.020, 0.048, and 0.00018, respectively). The tumor microvasculature was visualized by immunohistochemistry for CD31. en su mayor . 0000010226 00000 n
Se han descrito diversas clasificaciones, entre las que se destacan: la de Treves y Suderland, posteriormente la de Lester y Scout, pero resultan poco prácticas en cuanto al pronóstico del tumor, es por ello que inicialmente Norris y luego Azzopardi dividieron los tumores phyllodes en tres grandes grupos, en base a los siguientes parámetros:(1,2,7). Local recurrence occurred in 4 patients, with an actuarial 10-year rate of 8%. A pesar de las características de alto grado de malignidad, las pacientes pueden tener buen pronóstico si los tumores han sido extirpados quirúrgicamente en su totalidad. The atypia of the stromal cells and naked nuclei in a lesion considered benign clinically and on imaging alerted us to the possibility of a phyllodes tumor, despite the low cellularity of the preoperative fine-needle aspiration smears. Cytologically, hypercellularity of stromal cells with recognizable cytoplasm was observed in 6 of 7 borderline and malignant PT cases, but none of the benign PT or FA cases revealed such hypercellular stroma. 0000035922 00000 n
mientras que en el PT de bajo grado se muestran pocas o ninguna alteración. Keywords: Phyllodes tumor, cystosarcoma phyllodes, hamartoma, breast. Phyllodes tumors are rare lesions of the breast with unpredictable behavior. Se encontró adentroLa planificación estratégica de la comunicación en redes sociales se ha convertidoen una herramienta indispensable para la empresa de hoy en día. Journal of the Egyptian National Cancer Institute. Both breasts were affected equally. Archivos argentinos de pediatría, Jan 2010 .
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