title: Cystosarcoma phyllodes with muscular and lymph node metastasis. Our experience and review of the literature.
abstract: BACKGROUND
  Phyllodes tumors are biphasic fibroepithelial neoplasms of the breast. While the surgical management of these relatively uncommon tumors has been addressed in the literature, few reports have commented on the surgical approach to tumors greater than ten centimeters in diameter - the giant phyllodes tumor.
  
  
  METHODS
  We report a case of a 45-year-old woman who presented with a large lump in her right breast, involvement of multiple ipsilateral axillary lymph nodes and pectoralis major muscle. Clinical findings and cytologic examination (fine-needle aspiration) were suggestive of cystosarcoma phyllodes and we discuss the techniques utilized for pre-operative diagnosis, tumor removal, and breast reconstruction. A review of the literature on the surgical management of phyllodes tumors was performed.
  
  
  CONCLUSIONS
  Management of the phyllodes tumor presents the surgeon with unique challenges. The majority of these tumors can be managed by simple mastectomy. In our case clinical findings and cytologic examination (fine-needle aspiration) were suggestive of cystosarcoma phyllodes, for which the patient underwent a modified radical mastectomy. Postoperative radio therapy was given to the loco regional area.
  
  
  BACKGROUND
  Immediate reconstruction, Phylloides tumors, Post-operative radio therapy, Radical surgery.
authors.affiliation: Department of Endocrine Surgery, University of Perugia, Italy. a.sanguinetti@aospterni.it
authors.forename: Alessandro
authors.initials: A
authors.lastname: Sanguinetti
authors.forename: Giovanni
authors.initials: G
authors.lastname: Bistoni
authors.forename: Filippo
authors.initials: F
authors.lastname: Calzolari
authors.forename: Roberta
authors.initials: R
authors.lastname: Lucchini
authors.forename: Massimo
authors.initials: M
authors.lastname: Monacelli
authors.forename: Roberta
authors.initials: R
authors.lastname: Triola
authors.forename: Nicola
authors.initials: N
authors.lastname: Avenia
mesh_terms: D001943:Breast Neoplasms / Q000473:pathology*; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008875:Middle Aged; D019042:Muscle Neoplasms / Q000473:pathology*; D009361:Neoplasm Invasiveness; D003557:Phyllodes Tumor / Q000473:pathology* / Q000556:secondary*