Infiltrating ductal carcinoma developing within cystosarcoma phyllodes —A case report—

Malignancy in cystosarcoma phyllodes is uncommon and often confined to the stromal element. An extremely rare case of infiltrating ductal carcinoma developing within the stroma of cystosarcoma phyllodes is reported herein. A breast tumor with a diameter of 15 cm, which was diagnosed as cystosarcoma phyllodes, was excised from the right breast of a 47-year old woman. The histopathological examination revealed that hyperplastic ductal epithelial cells with dark cytoplasm and enlarged hyperchromatic nuclei were infiltrating the stroma. Thus, a diagnosis of ductal carcinoma within cystosarcoma was made. Subsequently, a standard radical mastectomy was performed. No recurrence or metastasis has been observed over the post-operative period of 5 years and 6 months.     

Infiltrating ductal carcinoma developing within cystosarcoma phyllodes--a case report

Malignancy in cystosarcoma phyllodes is uncommon and often confined to the stromal element. An extremely rare case of infiltrating ductal carcinoma developing within the stroma of cystosarcoma phyllodes is reported herein. A breast tumor with a diameter of 15 cm, which was diagnosed as cystosarcoma phyllodes, was excised from the right breast of a 47-year old woman. The histopathological examination revealed that hyperplastic ductal epithelial cells with dark cytoplasm and enlarged hyperchromatic nuclei were infiltrating the stroma. Thus, a diagnosis of ductal carcinoma within cystosarcoma was made. Subsequently, a standard radical mastectomy was performed. No recurrence or metastasis has been observed over the post-operative period of 5 years and 6 months.     

An emergent operation for metastatic cardiac tumor of malignant cystosarcoma phyllodes

A 47-year-old owman was transferred to our hospital under endotracheal intubation with severe hemodynamic deterioration. A left mastectomy had been performed 8 months earlier and histology of the specimen showed malignant cystosarcoma phyllodes. An angiography and echocardiography suggested massive mass of the right ventricle extending to the pulmonary artery. An emergent life-saving operation was required using cardiopulmonary bypass. A huge multilobular tumor was resected from the right ventricle through the pulmonary artery as much as possible and a tricuspid valvuloplasty was also performed. The patient was weaned from cardiopulmonary bypass, then satisfactorily recovered from hemodynamic disturbances. Nevertheless, she died 15 days later due to multiple organ failure. Microscopic examination of resected specimen showed the neoplastic stromal cells that increase mitotic activity and have sarcomatous characteristics, consistent with a metastatic cystosarcoma phyllodes. This is a second case of operation for cardiac metastasis of cystosarcoma phyllodes using cardiopulmonary bypass, so far presented in the literature of the world reviewed by the authors.     

Practical aspects in the diagnosis and management of cystosarcoma phyllodes

Thirty-five cases of benign cystosarcoma phyllodes, 13 cases of malignant cystosarcoma phyllodes, and ten cases of giant fibroadenoma were studied. The diagnosis of benign or malignant cystosarcoma phyllodes was based on a combination of histological features. Clinical and gross pathologic findings were not found to be useful in distinguishing between benign and malignant tumors. Giant fibroadenomas occurred primarily in black adolescents and were histologically distinct. Positive surgical margins were found to be the best predictor of local recurrence of benign or malignant cystosarcoma phyllodes. Systemic metastases occurred in only one case of malignant cystosarcoma phyllodes. Most benign and malignant cystosarcoma phyllodes may be treated by wide local excision with tumor-free margins. Giant fibroadenomas should be treated by simple excision to preserve normal breast tissue.     

Unilateral virginal breast hypertrophy

A case of unilateral virginal breast hypertrophy with a review of the etiological factors and treatment modalities is presented. A 16-year-old girl presented with progressive enlargement of the left breast of 5 months' duration. The result of the mammographic examination was consistent with cystosarcoma phyllodes. Fine-needle aspiration biopsy revealed giant fibroadenoma. Although some of the characteristics of the fine-needle aspiration biopsy specimen were suspicious for cystosarcoma phyllodes, there were no adequate epithelial structures, which are obligatory for the diagnosis. The patient was treated with subcutaneous mastectomy and subpectoral insertion of a silicone gel implant. The histopathological examination was consistent with virginal hypertrophy. The breast maintained its volume with no further growth in the affected or in the normal breast after 4 years of follow-up.     

Cystosarcoma phyllodes metastatic to a brenner tumor of the ovary.

A patient had cytosarcoma phyllodes that developed metastases to bone and to a Brenner tumor of the ovary. The original breast tumor was reported as benign, but the patient died of metastases four months following mastectomy. The rapid growth in the ovary may have been due to estrogenic stroma in the Brenner tumor. This is the first report, to our knowledge, of cystosarcoma phyllodes metastasizing to another tumor.     

精囊间质瘤1例报道

目的:探讨精囊间质瘤的临床表现、病理特点和诊治方法。方法:对1例精囊间质瘤进行回顾性分析,并结合国内外文献复习,从临床表现、病理特点、诊治方法及手术切除后疗效进行总结。结果:患者行连同肿瘤的精囊切除,病理报告符合精囊间质瘤,术后至今10个月超声、CT检查未见肿瘤复发。结论:精囊间质瘤临床少见,易漏诊、误诊。应常规行直肠指检,泌尿系超声,泌尿系CT、MRI有利于明确诊断。目前公认的治疗为切除肿瘤,预后良好。     

Dumbbell metastatic cystosarcoma phyllodes of the heart and lung

Cystosarcoma phyllodes is an uncommon breast tumor that rarely metastasizes. A case of dumbbell cystosarcoma phyllodes metastatic to the heart and lung diagnosed antemortem is described. The roles of diagnostic echocardiography and surgical excision are discussed. Atrial extension of a lung malignancy through a pulmonary vein is not an absolute contraindication to operation, but careful patient selection and operative planning are required.     

Extramammary cystosarcoma phyllodes with bilateral breast involvement

A 30-year-old woman presented with breast masses. One of the breast masses was clinically suggestive of cystosarcoma phyllodes. Excision of the breast masses revealed bilateral cystosarcoma phyllodes. A few weeks later another lump appeared in the left groin, and this on excision was found to be cystosarcoma phyllodes at an aberrant site. We consider it a unique clinical presentation of cystosarcoma phyllodes.     

精囊囊腺瘤1例报告并文献复习

目的:探讨精囊囊腺瘤的临床表现、病理特点和诊治方法。方法:对1例精囊囊腺瘤进行临床分析并结合文献复习,从临床表现、病理特点、诊治方法及疗效方面总结。结果:患者行连同肿瘤的精囊切除,病理报告符合精囊囊腺瘤,术后3个月超声、CT检查,未见肿瘤复发。结论:精囊囊腺瘤临床少见,易漏诊。常规直肠指检很必要,超声、CT有利于明确诊断。一般连同肿瘤的精囊切除即可,预后良好。     

Primary extraskeletal osteosarcoma of the seminal vesicle: a case report and literature review

A primary extraskeletal osteosarcoma (EOS) is a rare tumour. An EOS of the seminal vesicle has not been reported in the literature. We describe a case of a seminal vesicle EOS initially detected as a pre-rectal mass on a routine transrectal ultrasound in a 48-year-old man. A computed tomography (CT) scan confirmed the tumour to be arising from the left seminal vesicle. A robot-assisted laparoscopic seminal vesiculectomy was performed to avoid neurovascular bundle injury. Microscopic examination of the resected specimen showed a poorly differentiated osteosarcoma originating from the seminal vesicle. The patient received adjuvant chemotherapy. He is doing well without voiding or erectile dysfunction and he is tumour-free five months after surgery.     

Primary leiomyosarcoma of the seminal vesicle

A case of leiomyosarcoma of the seminal vesicle detected as a prerectal mass on routine per-rectal examination is described in a 37-year-old man. Computed tomography scan confirmed it to be arising from the right seminal vesicle. Per-rectal trucut biopsy showed malignant cells. Radical cystoprostatectomy with bilateral pelvic lymphadenectomy with anterior resection of rectum and urinary diversion with ileal conduit was performed. Microscopic examination of the resected specimen showed moderately differentiated leiomyosarcoma from the seminal vesicle. The patient received adjuvant chemotherapy and sandwiched radiotherapy. He is well and free of tumor 20 months after surgery.     

Zinner综合征一例报告并文献复习

目的 报告1例Zinner综合征病例,分析其诊治经过,并复习相关文献,提高对于本病的认识。方法 回顾性分析1例Zinner综合征病例,患者为18岁男性,因“反复尿频、尿痛、会阴区疼痛不适1年,加重伴发热1 d”入院。经影像学及实验室检查诊断为Zinner综合征。结果 入院后给予抗感染治疗7 d后临床症状消失,血常规、降钙素原、C反应蛋白感染指标正常,继续抗感染治疗1周出院。3个月后再次入院复查有轻度尿频,无尿痛症状,检查血常规无异常。行腹腔镜下左侧精囊囊肿切除术,术后病理明确精囊囊肿壁炎症浸润。术后5 d顺利出院。术后6个月内随访尿频、尿痛、会阴区疼痛等不适症状未再发。结论 彩超、CT、MRI检查是诊断Zinner综合征的重要手段,病理检查是明确精囊囊肿炎症浸润的依据。急性精囊囊肿感染伴同侧肾缺如、输尿管发育畸形是Zinner综合征的表现形式之一,感染控制后行腹腔镜精囊囊肿切除术安全有效。     

Treatment and outcome of cystosarcoma phyllodes in Brunei: a 13-year experience

Cystosarcoma phyllodes is a rare tumour of the breast whose clinical behaviour does not correlate well with histological findings. The optimal treatment of this tumour remains controversial. A retrospective study on the treatment and outcome of women diagnosed with cystosarcoma phyllodes between 1986 and 1998 in Brunei was undertaken. Twenty-seven women were diagnosed over the 13-year study period. Follow-up was complete in 26 cases. The mean age at diagnosis was 35 years. There were 19 (73%) histologically benign lesions, 3 (12%) borderline lesions and 4 (15%) malignant lesions. The mean follow-up period was 37 months. Four patients (16%) had recurrences after surgery (1 benign, 1 borderline and 2 malignant lesions). Mean time to recurrence was 9 months. Breast-conserving surgery with adequate resection margin is advocated in benign and borderline lesions. For malignant lesions, simple mastectomy without routine axillary dissection is recommended. More research is required to determine the role of adjuvant chemotherapy and radiotherapy in the management of malignant cystosarcoma phyllodes [corrected].     

Schwannoma of a seminal vesicle

We present the first reported case of a schwannoma of the seminal vesicle that occurred in a 48-year-old man who presented with right lower quadrant abdominal pain. Computed tomography scan and magnetic resonance imaging revealed a mass in the patient's right seminal vesicle. The patient was also found to have a rising prostate-specific antigen level and underwent a transrectal ultrasound-guided biopsy of the prostate and seminal vesicles, which revealed prostate cancer and schwannoma of the seminal vesicle, respectively. Radical prostatectomy with en bloc removal of the seminal vesicle mass was performed and the patient has been free of disease 24 months postoperatively.     

乳腺叶状囊肉瘤的钼靶、超声影像表现与病理对照研究

目的:评价乳腺叶状囊肉瘤钼靶X 线及超声影像学表现与手术病理组织学的相关性。材料和方法:回顾性分析12例经手术病理证实的乳腺叶状囊肉瘤术前钼靶X线及彩色多普勒超声影像学表现,并与手术病理标本进行对照分析,评价记录肿块部位、形态、大小、边缘、密度或内部回声、有无钙化、后方回声,内部血流和周围腺体结构、皮肤、乳头、腋窝淋巴结等影像学征象,分析影像学征象与病理组织学的相关性。结果:,钼靶组诊断符合率为75%,12 例乳腺叶状囊肉瘤患者钼靶组诊断乳腺叶状肿瘤8例,叶状囊肉瘤肿瘤1例,乳腺癌1例,乳腺良性肿块(纤维腺瘤)2 例。超声组诊断符合率为66.67%,诊断为叶状肿瘤7例,叶状囊肉瘤1例,乳腺癌2例,纤维腺瘤2例。结论:乳腺叶状囊肉瘤的钼靶X线和超声表现具有比较典型的影像特征,二者联合有利于早期发现本病,但叶状肿瘤的良恶性及叶状囊肉瘤的恶性程度与影像学表现无显著相关性,确诊主要依靠病理检查。     

Cystic schwannoma of a seminal vesicle

We present a case of a cystic schwannoma of the seminal vesicle that occurred in a 50-year-old man who presented asymptomatic. Computed tomography scan and magnetic resonance imaging revealed a cystic mass within the left seminal vesicle. A laparoscopic surgery was performed to remove the mass on request. Histopathological examination finally confirmed a schwannoma of the seminal vesicle. The patient was free of disease 3 months postoperatively.     

Malignant cystosarcoma phyllodes associated with scirrhous carcinoma of the breast: a case report.

The presence of a malignant cystosarcoma phyllodes in one breast and a scirrhous carcinoma in the opposite breast in a premenopausal Black woman is described. Malignant cystosarcoma phyllodes is uncommon and its rare association with carcinoma of the breast is mentioned.     

Malignant, locally recurring cystosarcoma phyllodes in an adolescent female. A case report

A 16-year-old girl presented with a large and rapidly growing cystosarcoma phyllodes in her right breast. The excised tumour showed unequivocal malignant characteristics at light and electron microscopy and was oestrogen-receptor negative. After repeated early local recurrences, a subcutaneous mastectomy ultimately led to local tumour control and the patient is now disease free 5.5 years after diagnosis.