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Pathology Research International
Volume 2010 (2010), Article ID 501274, 8 pages
http://dx.doi.org/10.4061/2010/501274
Case Report

Malignant Phyllodes Tumour with Liposarcomatous Differentiation, Invasive Tubular Carcinoma, and Ductal and Lobular Carcinoma In Situ: Case Report and Review of the Literature

1Division of Anatomic Pathology, Galway University Hospitals, Galway, Ireland
2Department of Radiation Oncology, Galway University Hospitals, Galway, Ireland
3Department of Surgery, Galway University Hospitals, Galway, Ireland
4Division of Pathology, Clinical Science Institute, National University of Ireland, Galway, Costello Road, Galway, Ireland

Received 20 December 2009; Accepted 11 April 2010

Academic Editor: Gary M. K. Tse

Copyright © 2010 Mardiana Abdul Aziz et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

A 43-year-old woman presented with a right breast lump that had enlarged over 5 months. She had chemoradiotherapy for non-Hodgkin’s lymphoma in 1989. Histology revealed a malignant phyllodes tumour (PT) with liposarcomatous differentiation and ductal carcinoma in situ (DCIS) within the tumour with invasive tubular carcinoma, DCIS, and lobular carcinoma in situ in the surrounding breast. She had surgery and adjuvant radiotherapy. One year follow-up showed no recurrence or metastatic disease. Liposarcomatous differentiation is uncommon in PTs, and coexisting carcinoma is rare with 38 cases in 31 reports in the literature. Carcinoma is reported in malignant ( 𝑛 = 1 9 ), benign ( 𝑛 = 1 6 ) and in borderline PTs ( 𝑛 = 3 ) with invasive carcinoma ( 𝑛 = 1 8 ) and pure in situ carcinoma ( 𝑛 = 1 9 ) recorded in equal frequency. Carcinoma is more commonly found within the confines of benign PTs; whereas it is more often found surrounding the PT or in the contralateral breast in malignant PTs. Previous radiotherapy treatment is reported in only two cases. The aetiology of co-existing carcinoma is unclear but the rarity of previous radiotherapy treatment suggests that it is incidental. This case highlights the diverse pathology that can occur with PTs, which should be considered when evaluating pathology specimens as they may impact on patient management.