J Breast Cancer.  2011 Sep;14(3):237-240.

Borderline Phyllodes Tumor with an Incidental Invasive Tubular Carcinoma and Lobular Carcinoma In Situ Component: A Case Report

• Quinlan-Davidson S
• Hodgson N
• Elavathil
• Shangguo T

Abstract

Phyllodes tumors are an infrequent breast tumor presentation. A phyllodes tumor with a synchronous invasive ductal carcinoma is rarely described and has never been reported with lobular carcinoma in situ component. A 53-year-old female presented with a nine-year history of twice core biopsy proven fibroadenoma. After an increase in the tumor's growth velocity it was decided upon to undergo an excisional biopsy. Microscopic examination of the well-circumscribed pale-tan mass found focal areas of leaf like architecture with variable number of mitoses present, representing a phyllodes tumor of borderline malignant potential. Incidentally, at one edge of the mass was found a tubular carcinoma and lobular carcinoma in situ components. Thorough, routine follow-up of patients with biopsy proven benign breast masses is important to finding a masked malignant component.

Keyword

Breast neoplasms; Breast screening; Fibroepithelial tumor; Mammography

MeSH Terms

Adenocarcinoma
Biopsy
Breast
Breast Neoplasms
Carcinoma, Ductal
Carcinoma, Lobular
Female
Fibroadenoma
Follow-Up Studies
Humans
Mammography
Masks
Middle Aged
Mitosis
Phyllodes Tumor

Figure

• 

  Figure 1 Ultrasound (US) of right breast multilobulated, solid mass measured 4.91×1.76 cm. Mildly heterogenous, paralleling the skin surface. In 2001 the tumor's longest US dimension was 2.4 cm.

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  Figure 2 Mammography of right breast, craniocaudal view, showed a circumscribed, multilobulated solid mass.

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  Figure 3 (A) The mass revealed fibroadenomatous change (H&E stain, ×40). (B) Leaf-like structures of fibroepithelial lesion showed a cellular stroma with cytological atypia and increased mitosis (H&E stain, ×40). (C) Invasive carcinoma cells formed small tubules within the stroma (H&E stain, ×20). (D) Tubules of carcinoma cells were immunohistochemically negative for myoepithelial marker, p63 (IHC, ×40). (E) Lobular carcinoma in situ was noted within the glandular component (H&E stain, ×40). (F) Lobular carcinoma in situ was immunohistochemically negative for E-cadherin (×40).

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