Malignant Phyllodes Tumor With Liposarcomatous Differentiation
Notice bibliographique
Résumé
A 47-year-old woman presented with a 1-year history of a palpable, asymptomatic breast mass. Her medical history was unremarkable. There was no family history of breast carcinoma. Her only medication consisted of oral contraceptives, and she was a nonsmoker. A solitary mass occupied most of the upper outer quadrant of the left breast. No axillary lymphadenopathy was identified. There were no palpable abnormalities of the right breast.The patient underwent ultrasound-guided core biopsies of the left breast, with the results suggestive of a malignant fibroepithelial neoplasm. A segmental mastectomy revealed a 5 × 5 × 5-cm, well-circumscribed, firm, and predominantly tan mass (Figure 1). This mass contained large clefts with leaflike projections, foci of tumor necrosis, and multiple areas that grossly resembled adipose tissue (arrow). Histologic examination of the tumor revealed a high-grade, malignant phyllodes tumor (PT) that was characterized by a pushing border and epithelial-lined clefts with hypercellular stromal overgrowth (Figure 2). The pleomorphic neoplastic stroma demonstrated a brisk mitotic rate and contained univacuolated and multivacuolated lipoblasts with hyperchromatic, pleomorphic, and scalloped nuclei (Figure 3). These areas resembled pleomorphic liposarcoma. No other sarcomatous elements were identified. The tumor was completely excised, and the patient remains well and disease free 16 months after surgery.Sarcomatous elements, including angiosarcoma, chondrosarcoma, leiomyosarcoma, osteosarcoma, and rhabdomyosarcoma, are rarely encountered in malignant PTs.1 Liposarcomas may also develop as stromal components of PTs. Liposarcomatous differentiation in PTs may consist of well-differentiated, myxoid, round cell, and pleomorphic liposarcomatous elements.23 Powell and Rosen3 described a series of 14 PTs with adipose differentiation that consisted of a single benign PT with lipomatous metaplasia (lipophyllodes tumor), 7 low-grade malignant PTs, and 6 high-grade malignant PTs. These tumors were all unilateral breast masses that developed in women with a mean age of 40 years. Mean tumor size was 4.0 cm. High-grade malignant PTs demonstrated large areas of stromal overgrowth that contained round cell and pleomorphic liposarcoma. No tumor recurrences were seen in the malignant PTs with adipose differentiation.3 The only tumor recurrence occurred when an incompletely excised lipophyllodes tumor recurred a year later as a high-grade malignant PT with pleomorphic liposarcomatous elements. In a series of 7 PTs with liposarcomatous elements, described by Austin and Dupree,2 only 1 patient experienced local tumor recurrence that developed 1 year after local excision.The clinical behavior of malignant PTs is difficult to predict. Liposarcomatous differentiation in malignant PTs, however, does not appear to equate with aggressive clinical behavior.23 Phyllodes tumors with liposarcomatous differentiation, like other PTs, require complete surgical excision to prevent local tumor recurrence.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,001 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».