Abstract |
Phyllodes tumors (PTs) of the breast are uncommon and account for < 1% of all breast tumors. Most patients present with mass lesions; however, there are rare reports of patients presenting with paraneoplastic conditions such as hypoglycemia secondary to insulin-like growth factor II secretion. A 55-year-old woman presented with a rapidly enlarging left breast mass which ulcerated through the skin and invaded the underlying muscle. The serum beta- human chorionic gonadotropin (beta-hCG) level was found to be 58 mIU/mL preoperatively; this dropped to 2 mIU/mL after surgery. Mastectomy showed a 14.5-cm fibroepithelial neoplasm, the majority of which was composed of a cellular spindle/epithelioid-cell proliferation with the focal presence of elongated epithelial clefts consistent with a PT. In addition to the presence of unequivocal sarcomatous stromal overgrowth and prominent mitotic activity, there were areas of lace-like osteoid production by tumor cells, and a diagnosis of malignant PT with osteosarcomatous foci was rendered. Immunohistochemical studies showed focal beta-hCG expression within the epithelioid stroma of the tumor; expression of p63 and cytokeratin was only seen in the epithelial component and there was no expression of placental alkaline phosphatase in either component. Although beta-hCG expression/production has been described in many nontrophoblastic tumors (mostly carcinomas of various organs), to our knowledge this is the first case documenting this in a PT of the breast. Whether this intriguing finding represents an isolated association or has more significant implications remains to be determined.
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Authors | Emily S Reisenbichler, Helen Krontiras, Omar Hameed |
Journal | The breast journal
(Breast J)
2009 Sep-Oct
Vol. 15
Issue 5
Pg. 527-30
ISSN: 1524-4741 [Electronic] United States |
PMID | 19624411
(Publication Type: Case Reports, Journal Article)
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Chemical References |
- Chorionic Gonadotropin, beta Subunit, Human
- HGF protein, human
- Hepatocyte Growth Factor
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Topics |
- Biopsy, Needle
- Bone Neoplasms
(pathology)
- Breast Neoplasms
(pathology, surgery)
- Chorionic Gonadotropin, beta Subunit, Human
(analysis)
- Female
- Hepatocyte Growth Factor
(analysis)
- Humans
- Immunohistochemistry
- Mastectomy, Modified Radical
- Middle Aged
- Necrosis
- Neoplasm Invasiveness
- Osteosarcoma
(pathology)
- Phyllodes Tumor
(pathology, surgery)
- Skin Ulcer
(etiology, pathology)
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