Surgical treatment and MRI in phyllodes tumors of the breast: our experience and review of the literature.
OBJECTIVE
To reassess the relationship between magnetic resonance imaging (MRI) findings and surgical resection margins in an attempt to address the issue of appropriate surgical management of phyllodes tumors (PT).


METHODS
Three female patients with a large palpable mass suspicious for phyllodes tumors were studied by mammography (MX), ultrasound (US) and dynamic MRI and then underwent surgery.


RESULTS
MRI demonstrated a rapidly and markedly enhancing multi-lobulated lesion. T1-weighted and T2-weighted sequences showed inhomogeneous signal intensity for the presence of cystic areas with internal septation and hemorrhage. Some areas of linear enhancement were present around the mass only in one case. Surgical management was mastectomy in one patient and wide excision in the other two patients. The margins in one of the latter patients were not clear, so mastectomy with immediate prosthetic reconstruction was subsequently performed. Pathological results showed 1 case of benign phylloides tumor, 1 case of borderline phylloides tumor and 1 case of malignant phylloides tumor.


CONCLUSIONS
MRI enabled complete visualization of the tumor even in the region close to the chest wall, as well as clear delineation from healthy glandular tissue and may help to define the appropriate surgical management of phylloides tumor.
Franceschini
Gianluca
G
Department of Surgery, "A. Gemelli" Medical School, Rome, Italy. gianlucafranceschini@yahoo.it
D'Ugo
Domenico
D
Masetti
Riccardo
R
Palumbo
Francesco
F
D'Alba
Pier Francesco
PF
Mulè
Antonio
A
Costantini
Melania
M
Belli
Paolo
P
Picciocchi
Aurelio
A
D000328:Adult; D001707:Biopsy, Needle; D001940:Breast / Q000473:pathology; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008327:Mammography; D008875:Middle Aged; D010173:Palpation; D003557:Phyllodes Tumor / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome; D016217:Ultrasonography, Mammary