From Fibroadenoma to Phyllodes Tumor: Case Analysis of Borderline and Giant Breast Tumors with Literature Review

Background: Phyllodes tumors are highly uncommon fibroepithelial neoplasms of the breast, accounting for less than 1% of all breast tumors. Differential diagnosis between phyllodes tumors and fibroadenomas by using imaging techniques such as ultrasound or mammography, as well as histological method...

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Main Authors: Justė Kazlauskaitė, Iryna Schmeil
Format: Article
Language:English
Published: Vilnius University Press 2025-02-01
Series:Acta Medica Lituanica
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Online Access:https://www.journals.vu.lt/AML/article/view/36719
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author Justė Kazlauskaitė
Iryna Schmeil
author_facet Justė Kazlauskaitė
Iryna Schmeil
author_sort Justė Kazlauskaitė
collection DOAJ
description Background: Phyllodes tumors are highly uncommon fibroepithelial neoplasms of the breast, accounting for less than 1% of all breast tumors. Differential diagnosis between phyllodes tumors and fibroadenomas by using imaging techniques such as ultrasound or mammography, as well as histological methods, can be challenging due to overlapping features. Phyllodes tumors are categorized into benign, borderline, and malignant types, each posing a different risk of recurrence and metastasis. Despite many advances in the imaging and biopsy techniques, diagnosing phyllodes tumors remains challenging. The purpose of this study is to review the existing literature on this topic and describe two cases of misdiagnosed phyllodes tumors. Materials and methods. A literature review was conducted by using the Medline (PubMed) database over 10 years. Information concerning the patients was sourced from the Uster Hospital database. After analyzing the cases of women with breast lumps from 2020 to 2023 in the Uster Hospital database, two cases of misdiagnosed phyllodes tumors were identified. These two cases were analyzed retrospectively. Results. A retrospective study of two cases confirms that phyllodes tumors are a rare phenomenon. A 51-year-old premenopausal woman presented with an 8 × 4 × 5 cm mass, initially diagnosed as a fibroadenoma. The final histopathology after surgical excision revealed a borderline phyllodes tumor with features overlapping those of a fibroadenoma. The second case involved a 59-year-old postmenopausal woman with a rapidly growing mass, which reached 11.9 × 11.3 cm and was initially diagnosed as a fibroadenoma but later confirmed as a borderline malignant phyllodes tumor with focal malignant components. Both cases highlight the limitations of imaging and core biopsy in accurately diagnosing phyllodes tumors and emphasize the need for comprehensive histopathological evaluation. The described clinical cases corresponded to the characteristics of phyllodes tumors indicated in the literature: they appeared in women older than 35 years, were hard to distinguish from fibroadenomas, and required surgical treatment. Conclusions. Phyllodes tumors are challenging to distinguish from fibroadenomas based on imaging and the initial biopsy results alone. Accurate diagnosis requires thorough histopathological examination following surgical excision. A multidisciplinary approach is essential for optimal management. Our cases show the complexity of phyllodes tumor diagnosis and the importance of considering phyllodes tumors in the differential diagnosis of breast masses, especially when clinical and imaging findings suggest a more aggressive pathology.
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spelling doaj-art-2eb12d0bedc64652b56ab38e7e7e660a2025-08-20T02:10:39ZengVilnius University PressActa Medica Lituanica1392-01382029-41742025-02-0132110.15388/Amed.2025.32.1.4From Fibroadenoma to Phyllodes Tumor: Case Analysis of Borderline and Giant Breast Tumors with Literature ReviewJustė Kazlauskaitė0https://orcid.org/0009-0002-2671-5584Iryna Schmeil1Faculty of Medicine, Vilnius UniversityDepartment of Gynecology and Obstetrics, Uster Hospital Background: Phyllodes tumors are highly uncommon fibroepithelial neoplasms of the breast, accounting for less than 1% of all breast tumors. Differential diagnosis between phyllodes tumors and fibroadenomas by using imaging techniques such as ultrasound or mammography, as well as histological methods, can be challenging due to overlapping features. Phyllodes tumors are categorized into benign, borderline, and malignant types, each posing a different risk of recurrence and metastasis. Despite many advances in the imaging and biopsy techniques, diagnosing phyllodes tumors remains challenging. The purpose of this study is to review the existing literature on this topic and describe two cases of misdiagnosed phyllodes tumors. Materials and methods. A literature review was conducted by using the Medline (PubMed) database over 10 years. Information concerning the patients was sourced from the Uster Hospital database. After analyzing the cases of women with breast lumps from 2020 to 2023 in the Uster Hospital database, two cases of misdiagnosed phyllodes tumors were identified. These two cases were analyzed retrospectively. Results. A retrospective study of two cases confirms that phyllodes tumors are a rare phenomenon. A 51-year-old premenopausal woman presented with an 8 × 4 × 5 cm mass, initially diagnosed as a fibroadenoma. The final histopathology after surgical excision revealed a borderline phyllodes tumor with features overlapping those of a fibroadenoma. The second case involved a 59-year-old postmenopausal woman with a rapidly growing mass, which reached 11.9 × 11.3 cm and was initially diagnosed as a fibroadenoma but later confirmed as a borderline malignant phyllodes tumor with focal malignant components. Both cases highlight the limitations of imaging and core biopsy in accurately diagnosing phyllodes tumors and emphasize the need for comprehensive histopathological evaluation. The described clinical cases corresponded to the characteristics of phyllodes tumors indicated in the literature: they appeared in women older than 35 years, were hard to distinguish from fibroadenomas, and required surgical treatment. Conclusions. Phyllodes tumors are challenging to distinguish from fibroadenomas based on imaging and the initial biopsy results alone. Accurate diagnosis requires thorough histopathological examination following surgical excision. A multidisciplinary approach is essential for optimal management. Our cases show the complexity of phyllodes tumor diagnosis and the importance of considering phyllodes tumors in the differential diagnosis of breast masses, especially when clinical and imaging findings suggest a more aggressive pathology. https://www.journals.vu.lt/AML/article/view/36719phyllodes tumorgiant phyllodes tumor
spellingShingle Justė Kazlauskaitė
Iryna Schmeil
From Fibroadenoma to Phyllodes Tumor: Case Analysis of Borderline and Giant Breast Tumors with Literature Review
Acta Medica Lituanica
phyllodes tumor
giant phyllodes tumor
title From Fibroadenoma to Phyllodes Tumor: Case Analysis of Borderline and Giant Breast Tumors with Literature Review
title_full From Fibroadenoma to Phyllodes Tumor: Case Analysis of Borderline and Giant Breast Tumors with Literature Review
title_fullStr From Fibroadenoma to Phyllodes Tumor: Case Analysis of Borderline and Giant Breast Tumors with Literature Review
title_full_unstemmed From Fibroadenoma to Phyllodes Tumor: Case Analysis of Borderline and Giant Breast Tumors with Literature Review
title_short From Fibroadenoma to Phyllodes Tumor: Case Analysis of Borderline and Giant Breast Tumors with Literature Review
title_sort from fibroadenoma to phyllodes tumor case analysis of borderline and giant breast tumors with literature review
topic phyllodes tumor
giant phyllodes tumor
url https://www.journals.vu.lt/AML/article/view/36719
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AT irynaschmeil fromfibroadenomatophyllodestumorcaseanalysisofborderlineandgiantbreasttumorswithliteraturereview