title: [A Case of Malignant Phyllodes Tumor Difficult to Distinguish from Spindle Cell Carcinoma].
abstract: A 70-year-old woman noticed a mass in her right breast. Breast ultrasonography showed a low echo mass with a smooth border to the greatest dimension measuring 5.4 cm. Needle biopsy showed an increase in the number of spindle-shaped cells with diffuse fascicles having nuclei with seasonal polymorphisms in the stroma, which led to the final diagnosis of spindle cell sarcoma. Immunohistochemistry analysis showed a CAM5.2-negative, AE1/AE3 partly-positive, bcl-2-positive, ER-negative, PgR-negative, SMA-positive, S-100-negative, desmin-negative, CD34-negative, and keratin 5/6-negative tumor that was suspected to be a phyllodes tumor. Differential diagnoses included sarcoma-likecance r, stromal sarcoma, and malignant phyllodes tumor. Breast mass resection was performed for a definitive diagnosis. The final pathological analysis showed a malignant phyllodes tumor. To date, we have encountered 1 case of malignant phyllodes tumor that was difficult to distinguish from a spindle cell sarcoma. Excisional biopsy is required for a definitive diagnosis.
authors.affiliation: Dept. of Surgical Oncology, Osaka City University Graduate School of Medicine.
authors.forename: Yuki
authors.initials: Y
authors.lastname: Okazaki
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Kashiwagi
authors.forename: Yuka
authors.initials: Y
authors.lastname: Asano
authors.forename: Wataru
authors.initials: W
authors.lastname: Goto
authors.forename: Koji
authors.initials: K
authors.lastname: Takada
authors.forename: Tamami
authors.initials: T
authors.lastname: Morisaki
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Takashima
authors.forename: Satoru
authors.initials: S
authors.lastname: Noda
authors.forename: Naoyoshi
authors.initials: N
authors.lastname: Onoda
authors.forename: Masahiko
authors.initials: M
authors.lastname: Ohsawa
authors.forename: Kosei
authors.initials: K
authors.lastname: Hirakawa
authors.forename: Masaichi
authors.initials: M
authors.lastname: Ohira
mesh_terms: D000368:Aged; D001707:Biopsy, Needle; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D002277:Carcinoma / Q000000981:diagnostic imaging*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D003557:Phyllodes Tumor / Q000000981:diagnostic imaging* / Q000601:surgery; D016896:Treatment Outcome