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

Table 1

Summary of cases of phyllodes tumours associated with carcinoma.

Report	Age	PT type	Size (mm)	Associated carcinoma		Location of carcinoma relative to PT	Comment	Outcome
				Invasive	In situ
Yamaguchi et al. [4]	54	BPT	150		DCIS	Within		AW at 11 months
Ramdass and Dindyal [5]	69	BPT	NS	IDC		Within	Complex carcinoma with clear cell, secretory and squamous differentiation	NA
Parfitt et al. [1]	26	BPT	33	IDC	DCIS	Within	Metastatic adenocarcinoma in 4 of 13 LN	AW at 36 months
Kodama et al. [6]	47	BPT	170	ILC	DCIS	Within	Lump present for 12 years before treatment	AW at 108 months
De Rosa et al. [7]	77	BPT*	50	IDC	DCIS	Ipsilateral	Mild atypia in stroma with occasional mitoses	AW at 10 months
Yasumura et al. [8]	47	BPT	130	IDC		Within		AW at 66 months
Knudsen and Ostergaard [9]	71	BPT	70		DCIS, LCIS	Within		NA
Grove and Deibjerg Kristensen [10]	71	BPT	190		DCIS	Within	History of irradiation to ovaries for climacteric menstrual disorders	AW at 4 months
Christensen et al. [11]	42–58	BPT	10–20	IDC		Ipsilateral	IDC in close relation to a recurrent PT	RIP after 3 months from metastatic carcinoma
Ishida et al. [12]		BPT	56	Papillotubular		Within		AW at 30 months
Stone-Tolin et al. [13]	59	BPT/NS	220	IDC		Contralateral	Recurring PT and FA over 36-year period	AW at 15 months
Leong and Meredith [14]	47	BPT	40	ITC		Within	Three recurrences of BPT. LCIS in second recurrence and ITC in third recurrence	AW at 21 months
Richards and WAY [15]	37	BPT	70	IDC**		Ipsilateral	Separate tumour nodules. Metastatic carcinoma in LN	RIP after 9 months from metastases^†
Lester and Stout, [16]	40	BPT	14	NS	NS	Ipsilateral	PT found in mastectomy specimen performed for carcinoma	AW at 144 months
Tan et al. [17]	NA	NS^∞	NA		DCIS	Ipsilateral		NA
Tan et al. [17]	NA	NS^∞	NA		LCIS	Within		NA
Deodhar et al. [18]	51	BLPT	140		DCIS	Within, Ipsilateral		NA
Christensen et al. [11]	42–58	BLPT	NS		DCIS	Within, Ipsilateral		RIP after 36 months from unrelated cause
Christensen et al. [11]	42–58	BLPT	NS		DCIS	Ipsilateral	Recurrent PT associated with DCIS in adjacent breast within 12 months of initial diagnosis	RIP after 12 months from metastatic PT
Korula et al. [19]	51	MPT	210		DCIS	Within, Ipsilateral	Metastatic carcinoma in 2 of 12 lymph nodes	AW at 11 months
Kefeli et al. [20]	26	MPT	45	IDC		Ipsilateral	Liposarcomatous and chondrosarcomatous stroma in PT; history of osteosarcoma and radiotherapy	RIP after 12 months^‡
Sugie et al. [21]	54	MPT	60	IDC	DCIS	Within	Carcinoma showed squamous differentiation	RIP after 40 months from metastatic PT
Merck et al. [22]	NS	MPT	NS	IDC		Contralateral		AW at 32 months
Nomura et al. [23]	75	MPT	35		DCIS	Within		AW at 32 months
Lim and Tan [24]	45	MPT	120		DCIS	Within	Liposarcomatous differentiation in PT; two FAs in contralateral breast	RIP after 108 months from unrelated cause
Tan et al. [17]	NS	MPT	NS		DCIS	Within
Auerbach [25]	69	MPT	NS	IDC		Ipsilateral	PT recurred after 40 months with metastases	RIP after 51 months from metastases^†
Gebrim et al. [26]	58	MPT	300	ILC		Contralateral	ILC within FA in contralateral breast	AW at 84 months
Nishimura et al. [27]	80	MPT	105		DCIS	Within	Osteosarcomatous, rhabdomyosarcomatous, fibrosarcomatous stroma in PT	RIP after 3 months from metastases^†
Padmanabhan et al. [28]	47	MPT	75		LCIS	Within	Liposarcomatous and fibrosarcomatous stroma in PT	AW at 6 months
Kasami et al. [29]	47	MPT	NS	ILC		Contralateral	46XX/46XY mosaic karyotype; three sisters with breast carcinoma. Recurrent PT at autopsy	NA
Powell and Rosen [30]	17–71	MPT	8–100		DCIS	Ipsilateral	Liposarcomatous stroma in PT	NA
Powell and Rosen [30]	17–71	MPT	8–100		LCIS	Contralateral	Liposarcomatous stroma in PT	NA
Powell and Rosen [30]	17–71	MPT	8–100	IDC	DCIS	Ipsilateral, Contralateral	Initially BPT, recurred as MPT with liposarcomatous differentiation in PT; Ipsilateral DCIS; Contralateral IDC	NA
Morimoto et al. [31]	49	MPT	110		LCIS	Contralateral	LCIS within contralateral FA	AW at 132 months
Christensen et al. [11]	42–58	MPT			LCIS	Ipsilateral		RIP after 12 months from metastatic PT
Huntrakoon [32]	31	MPT	90	IDC	DCIS	Ipsilateral		AW at 24 months
Seemayer et al. [33]	27	Stromal sarcoma***	60		DCIS	Within	Liposarcomatous differentiation in PT. Contralateral MPT after initial mastectomy	NA
Current case	43	MPT	35	IDC	DCIS, LCIS	Within, Ipsilateral	Liposarcomatous differentiation in PT. DCIS within PT. IDC and LCIS in ipsilateral breast. Previous radiotherapy for lymphoma.	AW at 12 months

*Category of PT not specified in original report, interpreted as benign PT.
**Classified as scirrhous adenocarcinoma.
***Sarcomatous stroma with liposarcomatous differentiation, tumour lacked circumscription and features of PT, for example, leaf-like structures were not present.
^†Metastatic component (sarcoma versus carcinoma) not specified.
^‡Cause not specified.
^∞Category of PT not specified.
AW: alive and well: BPT, benign PT: BLPT, borderline PT: DCIS, ductal carcinoma in situ: FA, fibroadenoma: IDC, invasive ductal carcinoma: ILC, invasive lobular carcinoma: ITC, invasive tubular
carcinoma: LCIS, lobular carcinoma in situ: LN, lymph node: MPT, malignant PT: NA, not available: NS, not specified.