| Abstract: | Cystosarcoma phylloides is not a single disease entity, but, a spectrum, which includes a benign, a non-metastatic malignant and a metastatic malignant form. Neither macroscopic nor microscopic examinations enable one to prediction as to whether the tumor is of a potentially metastatic kind or not. Neither pain nor infiltration or ulceration of the skin are reliable signs of malignancy; palpable axillary lymphnodes are misleading too. The treatment is composed of either a wide local excision of the tumor or a simple mastectomy. In cases where the lymphnodes have increased in size, simple mastectomy plus axillary lymphnodes dissection will be done. Since most tumor recurrence occurs following a local excision of the tumor only simple mastectomy is the surgical method of choid. The author presented two cases, examined by mammography; one case of malignant cystosarcoma phylloides malignum and one case of carcinoma. Both were similar in their clinical and radiographic presentation. Both cases demonstrate the difficulty of radiographie and pathologic diagnosis. A warning is given to radiologists not to compete with the pathologists for the histologic diagnosis but to limit themselves to suggest the presence of a possibly malignant tumor and the need for surgery. |
