乳腺分叶状肿瘤八例报告

Phyllodes tumors of the breast: a report of eight patients

回顾分析8例乳腺分叶状肿瘤患者的临床病理资料，良性2例，交界性2例，恶性4例，患者年龄29～50岁，平均年龄41岁。肿块最大径平均6．6cm（3～38cm）。4例有肿块短时间内迅速增大的病史，4例曾接受2～3次肿瘤局部切除术，1例行局部扩大切除术，2例行乳腺单纯切除术，3例行乳腺改良根治术，1例胸壁复发的巨大肿瘤行皮肤与肋骨的全层切除、背阔肌-侧胸-腹直肌跨区皮瓣转移修复，1例在20个月内做过5次手术。随访3～72个月，8例患者均生存，其中2例分别于首次手术后8和21个月出现肺转移。回顾分析提示，乳腺分叶状肿瘤术前诊断困难，易局部复发，保证切缘阴性的局部扩大切除术是治疗乳腺分叶状肿瘤的合适的手段。

The medical records of 8 patients with phyllodes tumors were reviewed. According to the criteria of the World Health Organization classification, tumors were classified into 3 groups： benign （2 cases）, borderline （2 cases）, and malignant （4 cases）. The mean age was 41 years （29-50 years）. The mean tumoral radius was 6.6 cm （3-38 cm）. Four patients had case history that tumor rapidly augmented in a short term; 4 patients had received tu-moral local excision for 2-3 times. One patient received wide local excision, two patients received simple mastecto-my, and three patients underwent radical mastectomy with axillary dissection. One case developing a huge tumor after recurrence in chest wall was performed of enblocn excision of chest wall from skin to costae, and the huge tissue de-fect was alternatively patched by combination flap of latissimus dorsi muscle, side chest and rectus abdominis. Anoth-er case had received 5 operations within 20 months. With 3 to 72 months follow up, all patients were alive, and 2 ca-ses of those respectively developed pulmonary metastases in 8 months and 21 months after the first operation. Based on the data from the literature and the authors＇ findings, it is concluded that the phyllodes tumor is characterized by its tendency to recur locally, and the preoperative diagnosis of phyllodes tumours remains difficult, and the wide local ex-cision of primary and recurrent lesions to obtaining negative margins remains the mainstay for therapy of the disease.