These tumors are bulky, benign tissues comprised of stromal connective tissue and epithelium, and are named because of their leaf-like appearance on histology. Phyllodes tumors typically occur in women in their 40’s, and are often resected with wide margins due to their small malignant potential and proclivity towards being locally invasive.
These tumors are rarely reported in younger adults, and the majority occur in women, typically presenting after menopause or during the perimenopausal period. The median age of presentation for phyllodes tumors is between 42 to 45 years of age. Though these are more common in patients in their 40’s, higher grade tumors are usually found in older individuals.
Phyllodes tumors are firm, large palpable masses which grow very fast. Despite being benign, these are locally aggressive tumors, and often are correlated with a history of rapid enlargement over a short period of time after initial detection.
The majority of phyllodes tumors are benign (85-90%), and the proportion of benign cases is higher in younger patients. While these benign tumors do not metastasize, they are locally aggressive and have tendencies to recur.
Though less common, malignancy can arise from 10-15% of phyllodes tumors. All forms of phyllodes tumors are regarded as having some degree of malignant potential. These metastasize hematogenously, and the lungs are the most common metastatic site, followed by the bones, heart and liver. There is roughly 30% mortality in patients with diagnosed with malignant phyllodes tumors.
Though most phyllodes tumors are benign, all phyllodes tumors are considered low-grade tumors. This is because even histologically benign appearing tumors may have malignant behavior.
These tumors are named for the Greek word “phullon,” which translates to leaf. On histology, these tumors are known for having "leaf-like" projections, hence their naming.
Phyllodes tumors are classified as stromal tumors, and on microscopy display hypercellular stroma (composed of fibrous cellular components) and cleft-like spaces lined by epithelium.
The definitive treatment for phyllodes tumors is wide resection (leaving large, 1-2 cm margins), as there is a small amount of malignant potential. These tumors are unresponsive to chemotherapy and radiation, though adjuvant therapy is helpful post-resection.
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