Our patients presented with a firm, mobile, well-defined, macrolobulated, and painless mass. Lymph node metastases are unusual and occur secondary to necrotic tumor. No patient had associated axillary lymph nodes enlargement. It is important to remember that core biopsy specimens reported as fibroadenoma with subsequent excision showing phyllodes tumor represent < 1% ( 10). Hyper cellular stromal fragments occur not only in Phyllodes tumor, but also in fibroadenoma, and hence they cannot be used as the sole criterion for making a diagnosis of Phyllodes tumor on FNA. Phyllodes tumors mimic fibroadenomas and are often excised with close margins. In our series, PTs happened exclusively in females. Malignant and borderline phyllodes tumors can metastasize more frequently, but metastases of benign phyllodes tumors were also reported ( 9). The borderline group had a standard deviation between the other groups because it had a wide range of ages, this is in controversy for the world wide studies as malignant PT has the eldest age ( 5), while in our study it is in the border line group (Table (Table1). The presence of an epithelial component differentiates the phyllodes tumor from other stromal sarcomas, all tumors are more or less locally aggressive and some of them have the ability to metastasize.īenign PT-group because this group had the highest number of cases, this is correlated with the world wide studies ( 5), In contrast, malignant PT-group had the smallest standard deviation because this group had the narrowest range of ages as it has a reduced number of cases. Phyllodes tumors (PTs) are rare fibro epithelial neoplasms with epithelial and cellular stromal components, the latter of which represents the neoplastic process. There is still confusion in the minds of surgeons and pathologists with respect to usefulness and accuracy of histologic assessment of malignancy. Pathologists and surgeons should have a healthy respect for phyllodes tumors. Unlike carcinomas of the breast, these tumors spread by blood vessel invasion bypassing the lymph nodes. Tumors that do metastasize often do so to the lungs. Grossly, there is lobulation of the tumor as the stroma proliferates resembling a leaf (phyllodes means leaf-like in Greek). They are variable in size and sometimes encompassing the entire breast. Thus, these tumors are divided into benign, border line and malignant. Management of the phyllodes tumor presents the surgeon with unique challenges.
Overall, they are rare tumors and represents 3% of fibroepithelial breast tumors and all are considered breast cancer, as even the benign form is regarded as having a malignant tendency or potential for metastasis ( 4). The phyllodes tumor, like the fibroadenoma, arises from the intralobular stroma of the breast. They make up 0.3 to 0.5% of female breast tumors and have an incidence of about 2.1 per one million women ( 2), the tumor is rarely found in adolescents and the elderly ( 3). It is a rare condition, and its cause remains unclear ( 1). The phyllodes tumor (PT), a lesion limited to mammary tissue, was first described by Muller in 1838. While one only had a previous positive resection margin without stromal overgrowth. In our series, we found that three patients of those with recurrence discovered to have stromal over growth. Four patients had recurrent tumors the distinctive features of those with recurrent tumors were the histological findings of stromal over growth and the presence of positive resection margin. The duration of symptoms varied from one month to ten year.s Six patients had painful swellings, whereas in twenty patients the pain was absent. With significant values of benign tumors occurrence (p5 cm. The types of Phyllodes tumors include: A-Benign phyllodes tumors (15 cases), B-Borderline phyllodes (7cases) and C-malignant phyllodes (4 cases). Out of the 26 patients diagnosed to have phyllodes tumor, 6 had breast-conserving therapy and 20 women had mastectomy. All our patients were females their age range between 17-67 years, the mean patient age at presentation was 39 years.
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