Ductal carcinoma in situ arising within a benign phyllodes tumor: A case report

Phyllodes tumor (PT) is a rare type of biphasic fibroepithelial neoplasm that accounts for <1% of all breast tumours and represents 2-3% of fibroepithelial neoplasms. Malignant transformation of PT usually occurs in the stromal component, and is rare in the epithelial component. DCIS, LCIS or invasive tumors might be due to epithelial component. We report a case of ductal carcinoma in situ (DCIS) occurring with in a benign PT. A 38-year-old multipar woman applied to an other medical center with compliants of a firm, palpable, irregularly-shaped lump with an ill-defined margin in the outer upper quadrant of the left breast. An ultrasound-guided core biopsy of this lump was done on an outpatient basis and the biopsy findings were benign PT with a DCIS component. The patients has undervent segmental mastectomy. The patology results were benign phyllodes tumor with Ductal Carcinoma In situ (DCIS). DCIS was also observed in a wide area of epithelial component (70% of epithelial component). The surgical margin were 1 mm away from the tumor. The patients had re-excision operation, however the surgical margin was still closed the margin so the patient had subcutaneous mastectomy with implant reconstruction. Large sized phyllodes tumors, malign phyllodes or epithelial tumors within phyllodes tumor can be resected with negative surgical margin with oncoplastic surgery techniques. Thus, it is possible to obtain successful results both in oncologic and cosmetically in phyllodes tumors.

Benign filloid tümörden geliþen duktal karsinoma in situ, bir vaka sunumu

Filloid tümör (FT), tüm meme tümörlerinin %1'inden azýný oluþturan nadir bir fibroepitelyal neoplazmdýr ve fibroepitelyal neoplazmlarýn % 2-3'ünü oluþturur. FT'ün malign transformasyonu genellikle stromal komponentin de gerçekleþir ve epitelyal komponentde malign transformasyon nadiren görülür. DCIS, LCIS veya invaziv tümörler nadiren de olsa epitelyal komponent kaynaklý olabilir. Biz benign bir FT'de ortaya çýkan duktal karsinoma in situ (DCIS) olgusunu sunuyoruz. 38 yaþýnda multipar kadýn hasta, sol meme üst dýþ kadranda sýnýrlarý belirsiz, düzensiz þekilli, sert, palpabl bir kitle þikayetiyle baþvurmuþ. Bu kitleden poliklinik koþullarýnda, ultrason eþliðinde kor biyopsi yapýldý ve biyopsi sonucu DCIS komponenti içeren benign FT olarak geldi. Hastaya segmental mastektomi uygulandý. Patoloji sonucu, duktal karsinoma in situ (DCIS) ile birliktelik gösteren benign filloids tümör þeklinde geldi. DCIS, epitelyal komponentin geniþ bir alaný (epitelyal komponentin % 70'i) içinde gözlendi. Cerrahi sýnýr tümörden 1 mm uzaktaydý. Hastaya re-eksizyon uygulandý, ancak cerrahi sýnýr yakýn geldi, bu nedenle hastaya implant rekonstrüksiyonu ile subkutan mastektomi uygulandý. Büyük boy filloid tümörler, Malign filloid tümörler veya epitelyal tümör içeren filloid tümörler, onkoplastik cerrahi teknikleri ile negatif cerrahi sýnýrla rezeke edilebilir. Böylece, filloid tümörlerde onkolojik ve kozmetik olarak baþarýlý sonuçlar elde etmek mümkündür.