Fibroadenomas are common benign neoplasms that may be treated conservatively. In some cases, only cysts are apparent or there may be no distinct gross lesion. Introduction: Periductal Stromal Sarcoma (PSS), especially spindle and epithelioid types, is a rare subtype of the malignant fibroepithelial tumor with benign ductal elements and a sarcomatous stroma composed of spindle cells. We present a woman aged 50 years who underwent a Tru-cut biopsy for a BI-RADS 4 lesion on her right breast and received a histopathology diagnosis of a fibroadenoma. Periductal stromal sarcoma is an extremely rare malignant fibroepithelial tumor of the breast which is characterized by its biphasic histology with benign ductal elements and a sarcomatous stroma . As far as we know, only sporadic cases were reported (1) (2)(3)(4)(5)(6)(7)(8 . . When severe, mastitis can lead to a breast abscess (5%-11%) or septicemia. Unlike phyllodes tumors, they do not present with a leaflike architectur The case of a 20-year-old female who presented with a lump in her left breast with clinical features mimicking fibroadenoma is reported, which has been recurrence-free for more than 38 months. Imaging Objective: To evaluate the histological characteristics of tumors labeled as fibroepithelial lesions of >breast tissues on trucut biopsy and compare with a . It is characterized by proliferation of atypical spindle cells . The majority of those affected are active smokers. Phyllodes tumor, also known as cystosarcoma phyllodes, is a rare fibroepithelial tumor of the breast which has some resemblance to a fibroadenoma. There may be scattered minute cysts. Breast; Breast Pathology; Breast Cancer; Introduction. Classification of breast lesions is an evolving process . the histologic features of periductal stromal sarcoma were defined as 1) a predominantly spindle cell stromal proliferation of variable cellularity and atypia around open tubules and ducts devoid of a phyllodes pattern, 2) one or more often multiple nodules separated by adipose tissue, 3) stromal mitotic activity of 3/10 high power fields, and PubMed Search: Phyllodes tumor of the breast[TI] full text[SB] pathology. A retrospective search of our Pathology database from 2000 to 2021 identified 6 PST, all evaluated according to the Armed Forces Institute of Pathology (AFIP) criteria. Phyllodes Tumor of the Breast Definition Mixed epithelial and stromal/mesenchymal proliferation of breast characterized by increased stromal cellularity and characteristic broad "leaf-like" papillae inserted into cleft-like spaces Alternate/Historical Names Cystosarcoma phyllodes Diagnostic Criteria Usually large and grossly circumscribed Macroscopic appearances Periductal stromal sarcoma: usually forms an ill-defined white/grey/tan/yellow mass. Breast cancer: abemaciclib (pending) atezolizumab histologic grading hormonal therapy inflammatory molecular subtypes multigene products neoadjuvant chemotherapy pertuzumab radiation therapy & cryoprobe spread and metastases trastuzumab triple negative breast cancer. J Periductal stromal tumor (PDST) is a rare biphasic tumor of the breast that exhibits low-grade malignancy and intermediate behavior. It is a challenge to diagnose the phyllodes by conventional trucut biopsy technique. Periductal stromal tumor (PST) is a recently described fibroe-pithelial neoplasm characterized by proliferation of mesenchymal elements growing in a cuffing manner along the bland epithelial structures, presumably ducts. Lakhani SR, Ellis IO, Schnitt SJ, et al. histologic criteria for pss according to the afip include: predominantly sarcomatous spindle cell stromal proliferation around open ducts and tubules, lack of leaf-like growth pattern, one or more nodules that can be separated by adipose tissue, mitotic activity equal to or more than 3 in 10 hpf and infiltration into surrounding adipose tissue ( Methods. 3. A retrospective search of our Pathology database from 2000 to 2021 identified 6 PST, all evaluated according to the Armed Forces Institute of Pathology (AFIP) criteria. Care should be taken when considering the diagnosis of fibroadenoma based only on clinical, radiological, and biopsy findings. Epidemiology Phyllodes tumors account for less than 0.3-1% of all breast neoplasms 13. PDSS is a distinct low-grade breast sarcoma, the appropriate diagnosis of which requires extensive tumor sampling and additional broad immunohistochemistry. Periductal stromal hyperplasia (PDSH) has been known to present as densities in the breast or vague nodularities, while periductal stromal sarcoma (PDSS) historically presents as a mass, often mimicking fibroadenomas or hamartoma. A diagnosis of low-grade periductal stromal sarcoma (PDSS) with myxoid features was established. Periductal mastitis is most common in younger, reproductive-age women. Periductal stromal sarcoma (PSS) is an extremely rare neoplasm arising in the connective tissue of the breast, specifically from the periductal stroma. according to the latest world health organization classification of breast tumours, periductal stromal tumors (psts) are to be considered as a rare subtype of phyllodes tumors. 2. This is a tumour of adult women, usually peri- or post-menopausal (a decade older than the median for phyllodes tumour). An extremely rare entity, the PST is actually classified as a subtype of phyllodes tumor, with specific criteria that are only found upon histological examination of the specimen. Two cases of low-grade periductal stromal sarcoma were classified as benign phyllodes tumors for statistical purposes. Introduction: Fibroadenomas (FAs) and phyllodes tumors (PTs) are less prevalent but allied to have malignant transformation in many instances. DOI: 10.1016/j.path.2017.09.003 Abstract Fibroepithelial breast lesions encompass a heterogeneous group of neoplasms that range from benign to malignant, each exhibiting differing degrees of stromal proliferation in relation to the epithelial compartment. Page views in 2022 to date: 72,633. . Am J Surg Pathol 2003; 27: 343-8. Periductal stromal tumors (PSTs) of the breast are considered as a rare subtype of phyllodes tumors. PMID: 30610048 Abstract Periductal stromal hyperplasia is an exceedingly rare biphasic breast tumor with benign ductal elements and spindle-cell stromal proliferation lacking a phyllodes architecture. The 3rd edition terminology of 'periductal stromal sarcoma' is revised to 'periductal stromal tumour', akin to the widespread consensus to avoid the use of the term 'cystosarcoma' in the context of phyllodes tumours. 1, 31 these tumors have inherent recurrence and/or metastatic potential, which varies based on histologic grade.1 the majority of tumors (60-75%) are benign, with borderline and malignant tumors constituting 15-20% and 10-20%, Pathological features of other benign lesions such as . Introduction. However, PDSS and PDSH may or may not form masses and vary in size, with a wide range (<1 cm to 24 cm). It has biphasic morphology with benign ducts and a sarcomatous stroma with no specific clinical or radiologic findings, which makes it difficult to diagnose (1-4).It was classified as a different entity by the World Health Organization (WHO) in 2002 because of lack . These rare fibroepithelial lesions display a biphasic morphology, characterized by a cellular stroma surrounding benign ducts. 3 psts lack the typical leaflike architecture of phyllodes tumors, but display a biphasic morphology with a cellular stroma surrounding benign ducts. Periductal stromal sarcoma in a child: a case report. It is unclear whether this tumor belongs to the spectrum of phyllodes tumor or is a separate entity. Follow-up information, mode of treatment and previous history of. WHO classification of tumors of the breast. Periductal stromal tumor (PST) is an extremely rare, low-grade neoplasm that arises from breast connective tissue. Periductal stromal sarcoma is an extremely rare malignant fibroepithelial tumor of the breast which is characterized by its biphasic histology with benign ductal elements and a sarcomatous stroma made of spindle cells and lacking phyllodes architecture. Periductal stromal tumor: a rare lesion with low-grade sarcomatous behavior. Papillary carcinoma: encapsulated papillary carcinoma solid papillary carcinoma. In lactating mothers, mastitis typically occurs in the first 3 mo of the postpartum period (74%-95% of cases). Methods. Periductal stromal tumor (PST) of the breast is a rare fibroepithelial neoplasm with controversial pathogenesis. Multinucleated stromal giant cells can be seen in . Breast periductal stromal tumor (PDST) is a rare condition and accounts for less than 1% of all breast malignancies. Its therapeutic management is based on wide surgery with free margins. 3, 7 the spindle Most recent WHO edition (2012) reclassified as "periductal stromal tumour" as the preferred "neutral term" in the family of fibroepithelial tumor Stromal proliferation around open, benign tubules Essential features Considered a type of fibroepithelial tumor lesion with stromal proliferation around benign tubules PSS is a distinct, low-grade breast sarcoma with no clinical or radiological specificity. Page views in 2021: 73,206. Phyllodes Tumor of the Breast Definition Mixed epithelial and stromal/mesenchymal proliferation of breast characterized by increased stromal cellularity and characteristic broad "leaf-like" papillae inserted into cleft-like spaces Alternate/Historical Names Cystosarcoma phyllodes Diagnostic Criteria Usually large and grossly circumscribed Phyllodes tumors. The therapeutic management of PSS is based on wide surgery with free margins, and adjuvant therapies are not required. A woman aged 50 years who underwent a Tru-cut biopsy for a BI-RADS 4 lesion on her right breast and received a histopathology diagnosis of a fibroadenoma and her final diagnosis was a periductal stromal tumor is presented. It is typically a large, fast growing mass that forms from the periductal stroma of the breast 13. Masbah O, Lalya I, Mellas N, et al. phyllodes tumors are rare, comprising 2.5% of fibroepithelial lesions and 0.3-1% of all primary breast tumors. Periductal stromal tumor: the periductal stromal tumor is an entity that histologically overlaps with malignant phyllodes tumor, the main difference being the absence of leaf-like processes. It is non-circumscribed, consisting of spindle-cell proliferation localized around open tubules. Lyon: IARC Press, 2012; 145. 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