Phyllodes tumors are extremely rare fibroepithelial tumors occurring during the pregnancy. Phyllodes tumors are graded (or classified) into benign, borderline and malignant. Since its first description in 1838, phyllodes tumors have presented a diagnostic and treatment dilemma. We herein report a case of a 32 years old lady presented with an aggressive growing right breast tumor at 20 weeks’ gestation. She had history of multiple right breast surgical excisions for fibroadenomas, benign phyllodes tumor, recurrent borderline phyllodes tumor and giant fibroadenoma. She underwent right simple mastectomy 4 days after delivery for painful fungating and ulcerating right breast tumor. The final histopathology reported as a benign phyllodes tumor.
Keywords: Benign, Breast, Phyllodes Tumor, Pregnancy, Recurrent
Introduction
Phyllodes tumors are rare fibroepithelial tumors which account for 0.3 to 1% of all primary neoplasm and 2.5% of all breast neoplasm (1). Grading (or classification) of phyllodes tumors into benign, borderline and malignant is based on semi-quantitative assessment of stromal cellularity, cellular pleomorphism, mitotic activity, margin appearance and stromal distribution (1, 2). It has overall 21% rate of local recurrence, with a 17%, 25% and 27% rate in benign, borderline and malignant respectively (1). Borderline and malignant phyllodes tumors have 4% and 22% rate of metastases respectively (1). Since its first description by Johannes Muller in 1838, phyllodes tumors have presented a diagnostic and treatment dilemma. Here, we presented a case of aggressive recurrent right benign phyllodes tumor during pregnancy and the managing dilemma encountered.
Case Presentation
32 years old lady at 28 weeks’ gestation presen...
... middle of paper ...
... any extra information. The core biopsy of the tumor on the other hand, shown a benign breast disease. Thus, the decisions on the timing of surgery and the type of surgery were crucial.
The timing of surgery was a difficult consideration. The risk for a surgery and general anesthesia during third trimester of pregnancy may outweigh the benefit for a benign breast disease and vice versa for malignant breast disease. Phyllodes tumor may exhibit a benign or malignant breast disease behavior. However, a benign phyllodes tumor can grow rapidly and cause local destruction. Thus, it was a challenging decision on when to perform the surgery.
The preferred choice of treatment was simple mastectomy because it was a recurrent tumor which almost covering the whole breast with discordance of tumor to breast ratio as well as the consensus from patient for a simple mastectomy.
Breast cancer was and still is the leading cause of death in women in the United States , and Dr. Halsted's number one goal was to reduce reoccurrence. He believed that the most effective way to reach this goal was to uproot the cancerous cells in the breasts, thus giving it its name "radical" mastectomy. The original mastectomy involved only removing the cancerous tumor, known today as a lumpectomy. After the aggressive disease returned, Halsted decided to remove the breast entirely. Frustrated with his negative results, he begins a tour through Europe to learn from some of the biggest names in surgery during the late 1800's throughout the early 1900's. Halsted wanted to keep cancer from taking over the body yet again. During his time in Europe, he witnesses his fellow surgeon, Volkmann, remo...
Most animals are susceptible to the development of cancer at some stage of their life. Among all types of cancer, squamous cell carcinoma is one of the skin cancer that commonly affects domestic animals. Cutaneous squamous cell carcinoma is a type of cancer caused by neoplasms arising from the squamous epithelium of an animal regardless of species. However, this essay will only focus on this condition among felines since my chosen species is a white cat called Rosie. There are several forms of cutaneous squamous cell carcinoma among felines, which are known as solar keratosis and multicentric squamous cell carcinoma in situ, sometimes known as Bowen’s-like disease, but in this case, Rosie is diagnosed with
The pancreas can be divided into two sections when studying the histology. The pancreas has exocrine and endocrine functions, each with unique cell types. The exocrine pancreas serves to secrete digestive enzymes into the duodenum. Some of the specific enzymes and secreted substances are Proteases, lipase, amylase, bicarbonate, and water (Bowen, “Exocrine Secretions”). These enzymes are used to break down protein, fat, and carbohydrates respectively. The bicarbonate simply act as an acid buffer to prevent damage of the small intestine as the stomach acid must be neutralized. The enzymes are created in acinar cells and the bicarbonate is synthesized in epithelial cells surrounding pancreatic ducts (Bowen “Exocrine
I have chosen to write about the constellation Cancer (The Crab). I chose Cancer because it is one of only a handful of constellations that I am actually able to identify in the night sky. Cancer is one of the twelve Zodiac constellations; people whose birthdays fall between June 21st and July 22nd have Cancer as their sign. Cancer is the Latin word for crab, and despite the fact that the constellation looks more like a lobster then a crab, it is still referred to as a crab. The constellation is visible from the northern hemisphere from late winter to early spring.
The fact that the study was conducted by qualified medical doctors authenticated the process of the study since the researchers had good knowledge of breast cancer. The study was also conducted in two separate countries, which widened the scope of the study thereby increasing the applicability in terms of geography.
Epithelial tumors are both benign and malignant tumors that develop in the epithelium, the thin layer of cells that cover the ovaries. These tumors usually form on the ovaries of women who have stopped their menstrual cycle. Malignant Epithelial tumors are the most frequent and deadly of all types of ovarian cancers. Together, benign and malignant Epithelial tumors account for 90% of all Ovarian cancer diagnoses.
Annette could not take that as a final answer and told her that she would not just leave it and should get a second opinion and have another test run. The patient went back and requested a more thorough test be completed, she got the results back and everything was clear and her primary care physician assured her she was fine. Initially she would perform the exams as learned in school, but now after finding something abnormal, she now does a more thorough check, especially on patients with a previous history of cancer. This incident solidified her belief in early detection and proper documentation.
Laughter is often said to reduce stress and produce pain reliving hormones. It is the ‘fountain of youth’, the secret ingredient to longevity. A person who laughs all the time is, more often than not, healthier and happier than a person who rarely laughs at all. Laughter is known as a natural form of medicine. However, like many other things, some people take the laughter and the jokes too far. This is the case in the story, “The Approximate Size of My Favorite Tumor,” by Sherman Alexie.
Skravanek, P. (1988). The debate over mass mammography in Britain: Br Med J; 297: 1542.
Jose MD, and Irma Russo, MD, "Susceptibility of the Mammary Gland to Carcinogenesis. Pregnancy Interruption as a Risk Factor in Tumor Incidence," The American Journal of Pathology, Aug. 1980
...lso recommend that their patients get an x-ray for the untreated breast as well. Doctors and patients are relieved quite a few times because a majority of breast cancers don’t recur, yet minorities of breast cancers do recur after several years. This is why doctors encourage their patients to come to their follow-ups. Doctors aren’t really sure that if the disease doesn’t recur in a few years it doesn’t mean it won’t. This cancer is slow growing so the disease may recur in about 10 to 20 years; however time does affect the likelihood of recurrence so if there are no signs of the cancer in the x-ray then there is a chance the disease won’t recur. Doctors and medical professionals can offer only so much support and every woman who has been diagnosed with is deals with the consequences of treatment and diagnosis no matter how strong she is needs emotional support.
Uterine Fibroids is a common medical condition that occurs generally in women in reproductive age. Fibroids are considered as benign tumors that grow up in the muscular wall of the uterus. Fibroids are also called leiomyoma or myoma. The size of the fibroids may vary from small sizes (apricot seed) to large sizes (similar to a melon). When fibroids rise up to a large size “The uterus expands to make it look approximating to a 6 or 7 months of pregnancy”. (Gynecologists). They also can grow up as an abnormal whole unit attach to the uterus or develop similar to grapes in different areas around the uterus. (See figure 1)
Bone cancer is classified into primary bone cancer & secondary bone cancer. Basically, Primary bone cancer starts in the bone; then the cancer initially forms in the cells of the bone; while the secondary cancer starts elsewhere in the body and gets spread to the bone.
The history of endometrial cancer is very vague, but there are a lot of factors and facts from previous patients that need to be concerned. From the sources that I have research, there was not a definite name that individuals could say discovered the cancer. Many scientists and doctors really do not talk about the cancer. This cancer basically has the supported information of how it happens, where it happens in the body, how can it be treated, and who to turn to when you need help. Endometrial cancer is found in the endometrium, which is the lining of the uterus. The endometrium which is found in a woman’s pelvic area and this is where the fetus grows until birth. Endometrial cancer occurs when cells of the endometrium begin to grow and multiply without the control mechanisms that normally limit their growth. As the cells grow, they form a tumor.
Breast Cancer is a type of cancer originating from breast tissue, most common from the inner lining of milk ducts. The most common type of breast cancer is called Ductal Carcinoma. Another type of breast cancer is Lobular Carcinoma, which begins in the lobules of the breast. Breast Cancer can occur in all men and women, sometimes male breast cancer is rare to happen. Breast Cancer can be two types it can be invasive or non-invasive. Invasive means that it has spread from the milk duct to the other parts of the breast and non-invasive means that it has infected other parts of the breast.