1/94. Molecular assessment of clonality leads to the identification of a new germ line TP53 mutation associated with malignant cystosarcoma phyllodes and soft tissue sarcoma.Cystosarcoma phyllodes (CSP) is a rare breast neoplasm composed of stromal and epithelial elements. It usually runs a benign course but it may metastasize. In a 31-year-old patient with recurring CSP, a mesenchymal tumor in the leg developed. The question arose whether the latter tumor could be a metastasis from the CSP, which would have major treatment consequences. The problem was addressed using molecular methods, i.e., comparison of the pattern of polymorphic repeat markers on chromosome 17p as well as single strand conformation polymorphism analysis and sequencing of exons 5 to 8 of the TP53 gene in both tumor and normal tissue. An identical pattern of loss of heterozygosity in both breast tumors was demonstrated, but a different pattern was shown in the tumor in the leg. This led to the conclusion that the latter tumor had to be a new primary tumor. A mutation in codon 162 of the TP53 gene was found in the tumor tissue as well as in the normal tissue of this patient. This germ line mutation leads to the replacement of isoleucine by asparagine and most likely has functional consequences. In all four examined tumors of this patient, the normal TP53 allele was lost. This is strong evidence that this germ line TP53 mutation causes the genesis of these two rare primary mesenchymal tumors in this young patient. The current study exemplifies the power of molecular diagnostic methods in investigating the specific clinical problem of clonal relation between two separate tumors. The germ line mutation found in codon 162 of the TP53 gene and the association with cystosarcoma phyllodes have not been described previously.- - - - - - - - - - ranking = 1keywords = breast (Clic here for more details about this article) |
2/94. Clinics in diagnostic imaging (35). Metastases to the breasts, skin and bone.A 46-year-old woman presented with multiple skin lumps and right hip pain. Multiple nodules were palpable in the skin over the chest and abdominal wall, and in both breasts. Bilateral mammograms showed multiple solid masses, while ultrasound demonstrated multiple subcutaneous nodules. An osteolytic lesion was seen on the right hip radiograph. Excisional biopsy of a subcutaneous nodule revealed metastatic adenocarcinoma. The diagnosis of metastases to the breast is discussed, together with imaging features of other multiple breast lesions, such as fibroadenomas and cysts.- - - - - - - - - - ranking = 3.5keywords = breast (Clic here for more details about this article) |
3/94. Secretory carcinoma of breast in an elderly female.Secretory carcinoma is the currently preferred designation for a unique neoplasm earlier thought to be exclusive to the adolescent/pre-menarchal breast. The neoplasm has a predilection for juveniles and young adults (< 30 years of age), becoming progressively less common with advancing age. This report is of one such instance in a 52 year old female, a rare occurrence in the elderly (> 50 years of age), with only five earlier cases on record in the English literature.- - - - - - - - - - ranking = 2.5keywords = breast (Clic here for more details about this article) |
4/94. Lobular carcinoma-in-situ within a fibroadenoma of the breast.We present a case of an in-situ lobular carcinoma within an otherwise benign fibroadenoma in a 45-year-old woman.- - - - - - - - - - ranking = 2keywords = breast (Clic here for more details about this article) |
5/94. Pleomorphic adenoma (benign "mixed" tumor) of the human female breast. Case report.A case of solitary pleomorphic adenoma, ("mixed" tumor of salivary gland type) of the left breast associated with the right breast fibroadenoma in 43-year-old woman is reported. The paper describes clinical, cytological, immunohistological and pathological findings in this case and indicates the importance of separating this benign entity from malignances with stromal metaplasia.- - - - - - - - - - ranking = 3keywords = breast (Clic here for more details about this article) |
6/94. Carcinoma in a fibroadenoma.A carcinoma arising within a fibroadenoma is an unusual occurrence, with only a little over 100 reported cases. The purpose of this report is to increase the awareness of this entity and to discourage the practice of rendering a diagnosis on gross examination of the tumor. We are reporting a case with two distinct primary tumors within the same breast, one of which was arising within the fibroadenoma. Only two such cases have been previously reported.- - - - - - - - - - ranking = 0.5keywords = breast (Clic here for more details about this article) |
7/94. Malignant phyllodes tumor in the right breast and invasive lobular carcinoma within fibroadenoma in the other: case report.CONTEXT: The malignant variety of the phyllodes tumor is rare. The occurrence of invasive lobular carcinoma within fibroadenoma is rare as well. DESIGN: Case report. CASE REPORT: A 58-year-old black female patient was referred to the Mastology unit of the Department of gynecology, Federal University of Sao Paulo / Escola Paulista de Medicina, in February 1990, presenting an ulcerated tumor in the right breast with fast growth over the preceding six months. She was a virgin, with meno-pause at the age of 45 years and had not undergone hormone replacement treatment. The physical examination showed, in her right breast, an ulcerated tumor of 20 x 30 cm which was not adher-ent to the muscle level, multilobular and with fibroelastic consistency. The axillary lymph nodes were not palpable. The left breast showed a 2 x 3 cm painless, movable nodule, with well-defined edges, and fibroelastic consistency. We performed left-breast mammography, which showed several nodules with well-defined edges, the largest being 2 x 3 cm and exhibiting rough calcification and grouped microcalcifications within it. The patient underwent a frozen biopsy that showed a malignant variant of the phyllodes tumor in the right breast and fibroadenoma in the left one. After that, we performed a total mastectomy in the right breast and an excision biopsy in the left one. paraffin study confirmed the frozen biopsy result from the right breast, yet we observed that in the interior of the fibroadenoma that was removed on the left, there was a focal area of invasive lobular carcinoma measuring 0.4 cm. The patient then underwent a modi-fied radical mastectomy with total axillary lymphadenectomy. None of the 21 dissected lymph nodes showed evidence of metastasis. In the follow-up, the patient evolved asymptomatically and with normal physical and laboratory examination results up to July 1997.- - - - - - - - - - ranking = 5.5keywords = breast (Clic here for more details about this article) |
8/94. Malignant phyllodes tumor with liposarcomatous components: a case report with cytological presentation.Cytological and histological findings of a rare case of a malignant phyllodes tumor (with liposarcomatous components) of the breast are presented. The atypia of the stromal cells and naked nuclei in a lesion considered benign clinically and on imaging alerted us to the possibility of a phyllodes tumor, despite the low cellularity of the preoperative fine-needle aspiration smears. The excisional biopsy was histologically diagnosed as malignant phyllodes tumor with liposarcomatous components. Peculiar atypical cells with large, pale, transparent cytoplasm, or with intranuclear chromatolytic areas similar to intranuclear cytoplasmic inclusions, in addition to atypical lipoblasts revealed in imprint smears from the excised tumor, may be important for cytopathologists to achieve a definitive cytological diagnosis, and also to observe patients over long periods for recurrences and metastasis after surgery for this rare breast tumor.- - - - - - - - - - ranking = 1keywords = breast (Clic here for more details about this article) |
9/94. fibroadenoma of the vulva.A well-circumscribed mass was excised from the vulva of a 37-year-old woman. Histological and immunohistochemical findings showed the characteristic features of fibroadenoma of breast. The concepts about the histogenesis of this lesion were discussed.- - - - - - - - - - ranking = 0.5keywords = breast (Clic here for more details about this article) |
10/94. 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.- - - - - - - - - - ranking = 4keywords = breast (Clic here for more details about this article) |
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