Malignant phyllodes tumor

Last revised by Daniel J Bell on 2 Oct 2024

Malignant phyllodes tumor of the breast, also known as phylloides tumors, accounts for up to a quarter of the phyllodes tumors.

Please, refer to the main article on phyllodes tumors for a general discussion. 

It is generally thought that it is the stromal component that becomes malignant 4. This may account for their hematogenous metastatic pattern.

A substantial overlap in the imaging characteristics has been reported between benign and malignant phyllodes tumors. A tumor diameter of 3 cm or greater has been generally reported to be associated with a higher likelihood of malignancy 3.

Fewer than 20% of the malignant tumors metastasize. When metastatic disease does occur, the metastases usually spread hematogenously to the lungs, pleura, or bone. Surgery is the mainstay of treatment as they are not proven to be sensitive to radiotherapy or chemotherapy. Because lymphatic metastasis is rare, axillary nodal surgery is not indicated.

The name phyllodes is derived from the Greek word: "phyllon" meaning "leaf" and "eidos" meaning formPhyllodes tumors were first described in 1838 by Johannes Muller as "cystosarcoma phyllodes".

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