悪性線維性組織球腫様の組織像を呈した乳腺再発悪性葉状腫瘍の1例

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  • A CASE OF RECURRENT MALIGNANT PHYLLODES TUMOR OF THE BREAST WITH FEATURES OF MALIGNANT FIBROUS HISTIOCYTOMA

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We have encountered a rare case of recurrent malignant phyllodes tumor of the breast with features of malignant fibrous histiocytoma.<br> A 53-year-old woman underwent a resection and transposition of the latissmus dorsi muscle for a benign phyllodes tumor in the breast. Three months later, a painful induration was observed into the wound. Fine-needle aspiration cytology was carried out three times and showed only blood. There was a suspicion of hematoma on ultrasonography and computed tomography. Soon, redness and induration at the punctured skin were observed and thus a biopsy was conducted. Moderate mitotic activity and stromal atypia were revealed and the tumor was diagnosed as borderline phyllodes tumor. Clinically, infiltration into the pectralis major muscle was suspected, and a mastectomy was added to the patient. Histopathologically, spindle shaped cells were arranged in a storiform pattern and tumor cells were pleomorphic with benign duct epithelium. Cellularity and mitotic activity were considered high. The tumor was diagnosed as malignant phyllodes tumor with features of malignant fibrous histiocytoma. Pathological fracture of the humerus occurred 3 months after the operation and metastases to the lung and liver were found. The patient did not respond to chemotherapy and died 8 months after the operation.

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