乳腺叶状囊肉瘤1例报告并文献复习

Breast cytosarcoma phyllodes: a case report with review of literature

目的:报道乳腺叶状囊肉瘤1例,并探讨其临床病理特征、诊断及治疗方法。方法:回顾性分析1例乳腺叶状囊肉瘤患者的临床资料,结合相关文献进行病理、病因、诊断及治疗等方面的讨论。结果:本例患者曾因"乳腺纤维瘤"先后6次手术,第6次手术诊断为恶性分叶状肿瘤,术后半年出现胸壁、牙龈转移,胸壁、牙龈肿物切除术后,发现颧面部、上颌窦、胸椎多发转移,行2周期化疗,临床症状获得缓解,后因经济原因放弃治疗,随访3个月患者死亡。结论:乳腺叶状囊肉瘤由良性上皮成分和富于细胞的恶性间质成分组成,细针穿刺细胞学检查诊断价值有限,常需要手术获取完整标本,并结合免疫组化进行诊断。一旦出现复发或远处转移,应行全面检查明确病灶范围,进行综合治疗。其临床表现具有异质性,复发及远处转移者预后较差。

Objective：To report a case of breast cytosarcolna phyllodes,and to discuss the clinical pathological characteristics, diagnosis and treatlnent. Methods ： To discuss the pathology, etiology, diagnosis and treatlnent by retrospectively analyzing the clinical data of one patient with breast cytosarcolna phyllodes and colnbining with the relevant literature. Results：The patient had undergone surgery operation for five tilnes because of ＂ breast adenofibroma＂. She was diagnosed as lnalignant phyllodes tulnor in the sixth surgery. She appeared the lnetastasis of chest wall, ginival postoperative half a year. After chest wall, ginival neoplasms resection,she appeared zygomatieofacial, maxillar sinus, thoracic multiple metastases. After 2 cycles chemotherapy,the clinical symptom acquired some remission. However,the patient gave up the treatment finally because of financial difficulty. After a follow- up of 3 months, the patient died. Conclusion：Breast eytosareolna phyllodes is eolnprised of benign epitheliuln and lnalignant stromal eolnponent, while the value of fine - needle aspiration biopsy in the diagnosis is limited. Therefore, in order to diagnose exactly,we often need to obtain the full specilnens through the surgery, and to colnbine it with ilnlnunohistochelnistry. Once the disease recurrences or distant lnetastase, happen then a set of overall physical exalnination is neeessary to gain a eolnprehensive and exact treatlnent, it has the features of heterogeneity,and the prognosis lnight be poor in the patients with recurrence and distant lnetastase.