Revista chilena de obstetricia y ginecología
On-line version ISSN 0717-7526
MARTINEZ RM, Alejandra et al. TRANSFORMACIÓN OSTEOSARCOMATOSA DE TUMOR PHYLLODES MAMARIO. Rev. chil. obstet. ginecol. [online]. 2008, vol.73, n.4, pp. 273-276. ISSN 0717-7526. http://dx.doi.org/10.4067/S0717-75262008000400010.
Background: Phyllodes tumor (TP) is a rare tumor. The majority of them have been described as benign, with the reminder divided between borderline and malignant tumors. Case description: 47-year-old patient derived to our hospital to evalúate a recurrent TP after three local failures. Surgical removal of tumor had positive margins in the previous surgeries. She presented to our service with a nodule in the scar that was resected. The pathology diagnosis revealed a poor differentiated osteosarcoma. As surgical margins were cióse, the treatment was completed with a wide local reexcision and adequate surgical margins plus chemotherapy. Múltiple pulmonary nodules compatible with metástasis were targeted in the thoracic TC during follow-up and another chemotherapy scheme was initiated. The patient did not respond and died due to the progression of her pulmonary disease. Discussion: Surgical removal is the mainstay of TP treatment and wide excisión with adequate margins superior to 1 -2 cm remains the treatment of choice. Lymphatic spread is uncommon and axillary metastases occur in less than 5-10% of patients, and therefore routine axillary dissection is not necessary. Conclusión: An incomplete resection in a malignant TP favours stromal overgrowth and sarcomatous transformation, which has very poor prognostic features.
Keywords : Phyllodes tumor; breast osteosarcoma; metastases.