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Title   악성 엽상낭육종 ( Malignant Cystosarcoma Phyllodes )
Publicationinfo   1992 Jan; 024(05): 730-737.
Key_word   Cystosarcoma phyilodes, Breast cancer
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Abstract   Because of its rarity among the breast tumors, malignant cystosarcoma phyllodes is one of the unfamiliar disease to both surgeon and pathologist. The outcome of these patients after treatment is difficult to predict, if it is determined merely by the clinical features or pathologi- cal findings of the patients. Therefore the unpredictable potential of the recurrence and me- tastasis of this disease is the most annoying problem to both pathologist and surgeon who must decide the extent of the operation. We have retrospectively analyzed the 7 female patients with the malignant cystsarcoma phyllodes of the breast who were treated at Department of Surgery, Seoul National University HospitaL The age distribution af them was from 22 to 75 years of age(mean age; 37 years). The third and faurth decades in age comprised the half of the cases. The palpable mass was the most common chief complaints. The duration of the symptom was from 1 month to 30 years. Two patients had masses larger than 7 cm in diameter, and one patient less than 4 cm. Four patients had their lesions on the right side. One patient was suspected to present the enlargement of the axillary lymph node with no evidence of axillary metastasis by pathology. As a seperate lesion, infiltrating duct carcinoma was observed on the ipsilateral side in one patient. Past history of the recurrence was identified in one patient. There were 14 benign, and 7 malignant cases(33%) during observed period. The microscopic findings were as follows; high cellularity of the tumor cells was observed in 5 patients(71.4%), with infiltrating contours in 3 patients(42.9%). The mitoses per 10 HPF were more than 5 in all cases. The cellular atypia was high in 3 patients(42.9%). Microscopic hemorrhage and necrosis of the tumor cells were seen in 2 patients(28.6%) respectively. No axillary lymph node was invaded by tumors. Simple mastectomy with the axillary dissection or sampling were performed to all patients except one. Adjuvant therapy included chemotherapy and radiotherapy was practiced in 3 patients after the surgery. Follow-up of the patients was possible in 5 patients, and its duration varied from 1 month to 59 months. No recurrence or metastasis occured during this period. These results suggest that the prognosis of this disease can not be predicted by clinical features or microscopic grades independently, and simple mastectomy without axillary dissertion is sufficent for the treatment.
저 자   노동영(Dong Young Noh),김수진(Soo Jin Kim),최국진(Kuk Jin Choe),김진복(Jin Pok Kim),김우호(Woo Ho Kim)