Phyllodes Tumor: A Rare Case with Cervical Vertebral Metastasis

Abstract

Background Phyllodes tumor or cystosarcoma phyllodes is a rare tumor that accounts for less than 1% of breast lesions. Incidence of these lesions metastasizing to distant sites is very low and only a few cases of metastases to central nervous system have been reported. The management of a case with cervical spine metastasis is described and current literature has been reviewed.

Case Description A 32-year-old woman who underwent excision of cystosarcoma phyllodes of the right breast presented with neck pain. Evaluation showed destruction of the C3–C4 vertebrae. Anterior decompression with anterior and posterior fusion was done, followed by radiotherapy.

Conclusion Spinal metastasis from cystosarcoma phyllodes is extremely rare, but should be kept in mind when a patient presents with symptoms suggestive of a spinal problem. Surgical management of these tumors may enhance the quality of life of these patients.

Keywords

cystosarcoma phyllodes - cervical spine - metastasis - vertebrae

• References

• 1 Rosenfeld JC, DeLaurentis DA, Lerner H. Cystosarcoma phyllodes. Diagnosis and management. Cancer Clin Trials 1981; 4 (2) 187-193
• 2 Telli ML, Horst KC, Guardino AE, Dirbas FM, Carlson RW. Phyllodes tumors of the breast: natural history, diagnosis, and treatment. J Natl Compr Canc Netw 2007; 5 (3) 324-330
• 3 Lee BJ, Pack GT. Giant intracanalicular myxoma of the breast, so-called cystosarcoma phyllodes mammae of Johannes Muller. Ann Surg 1931; 93 (1) 250-268
• 4 Dyer NH, Bridger JE, Taylor RS. Cystosarcoma phylloides. Br J Surg 1966; 53 (5) 450-455
• 5 Grimes MM, Lattes R, Jaretzki III A. Cystosarcoma phyllodes. Report of an unusual case, with death due to intraneural extension to the central nervous system. Cancer 1985; 56 (7) 1691-1695
• 6 Moffat CJC, Pinder SE, Dixon AR, Elston CW, Blamey RW, Ellis IO. Phyllodes tumours of the breast: a clinicopathological review of thirty-two cases. Histopathology 1995; 27 (3) 205-218
• 7 Palmer ML, De Risi DC, Pelikan A , et al. Treatment options and recurrence potential for cystosarcoma phyllodes. Surg Gynecol Obstet 1990; 170 (3) 193-196
• 8 Rhodes RH, Frankel KA, Davis RL, Tatter D. Metastatic cystosarcoma phyllodes. A report of 2 cases presenting with neurological symptoms. Cancer 1978; 41 (3) 1179-1187
• 9 Hlavin ML, Kaminski HJ, Cohen M, Abdul-Karim FW, Ganz E. Central nervous system complications of cystosarcoma phyllodes. Cancer 1993; 72 (1) 126-130