Friday, December 4, 2009

Cystosarcoma Phylloides



41 year old Malay lady presented with 5 years history of right breast lump. The lump was about the size of a marble when it was first discovered accidentally by palpation but has grown to a size of a small fist within a year. It has since remained the same size over the next 4 years.She does complain of occasional pain during menses. Otherwise, there was no loss of appetide, loss of weight, changes in the skin over the breast or nipple discharge.
Ultrasound showed a large 7cm oval-shaped well-defined but lobulated mass. Multiple small areas of cystic degeneration and specks of calcifications are present.
A diagnosis of benign cystosarcoma phylloides was made. She was advised surgery.
Cystosarcoma phylloides is also known as giant fibroadenoma. However, its peak age is 30 to 40 years i.e 10 years after fibroadenoma. They are rare, usually unilateral and have malignant potential.
Sonographic appearance is similar to fibroadenoma. There may be cystic spaces from hemorrhage or necrosis. However, ultrasound is not able to differentiate benign from malignant phylloides.

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