Spontaneous Regression Of Pulmonary Metastases From A Malignant Phyllodes Tumor
Sadatomo, A., Hozumi, Y., Shiozawa, M., Hirashima, Y., Koinuma, K., & Kurihara, K. (2011). spontaneous regression of pulmonary metastases from a malignant phyllodes tumor. Japanese journal of clinical oncology, 41(7), 915–917. https://doi.org/10.1093/jjco/hyears056
View Original Source →Abstract
We report a case of spontaneous regression of pulmonary metastases from a malignant phyllodes tumor. A 50-year-old woman was diagnosed with a breast phyllodes tumor. Computed tomography and positron emission tomography revealed multiple lung metastases. She underwent a mastectomy to control the pain of the enlarging breast mass. Histopathologic examination diagnosed a malignant phyllodes tumor. Without the administration of any adjuvant therapy, the follow-up chest computed tomography scan and positron emission tomography scan showed disappearance of the lung metastases 2 months after surgery.
Case Details
Disease Location
Breast with lung metastases
Personal Characteristics
50 year old female
Clinical Characteristics
Referred with severe anemia and a mass of the left breast. Physical examination revealed a hard and tender mass, which measured 10 cm in size. The skin overlying the mass was erythematous CT scan revealed that the tumor was a heterogeneous mass with solid components and necrotic areas. Laboratory findings showed normocytic anemia and signs of an inflammatory reaction. Bone marrow biopsy revealed normocellularity without dysplasia and decreasing numbers of sideroblasts, reflecting the reduced availability of iron for red cell production. She was diagnosed with anemia from chronic inflammation. She received blood transfusions. A core needle biopsy was performed, which showed a fibroepithelial tumor formed by an organoid pattern of ductal structures suggestive of a phyllodes tumor. CT scan showed multiple lung tumors. PET scans revealed a tumor of intense fdg activity in the left breast and multiple regions of abnormal fdg activity in the lung. The lung tumors were diagnosed as metastases from the phyllodes tumor. One month after initial evaluation, she underwent a left mastectomy. The tumor was 12x9x7 cm in size, and showed stromal hypercellularity, nuclear pleomorphism, stromal overgrowth composed of spindle cells forming leaf-like ducts and necrotic elements, consistent with a malignant phyllodes tumor
Remission Characteristics
The hemoglobin and inflammation markers (crp) returned to the normal range after surgery. Approximately 3 months later, follow-up CT and PET scans revealed that the multiple lung metastases had disappeared.
Treatment & Mechanisms
Proposed Remission Mechanisms
Host immune system
Clinical Treatment
Needle core biopsy bone marrow biopsy mastectomy of left breast 1 month post diagnosis