The role of visualization in the diagnosis of phyllodes tumors

Abstract

Relevance. Phyllodes tumors (PT), or cystosarcoma phylloides, are rare fibroepithelial tumors of the mammary gland, similar to fibroadenoma. Usually large, fast-growing, originate from the periductal stroma. They are classified as benign, borderline and malignant by histology, but all are potentially malignant. Accurate diagnostics are important for choosing surgical tactics. Objective of the study. To evaluate the radiological and histopathological characteristics of PT in patients examined at the National Cancer Center. Materials and methods. Retrospective analysis of PT cases for January 2024 - April 2025. All patients underwent mammography and ultrasound. Data were obtained from electronic medical records. Results and discussion. 50 cases were identified: the average age was 28 years for benign, 35 years for borderline, 45 years for malignant. Borderline and malignant were larger (35-40 mm). In 38% of cases, the formations were mistakenly assessed as fibroadenomas, in 24%, the philoid tumor variant was indicated as a possible diagnosis. On mammography, most benign (65%) and 35% of malignant tumors had a high density; calcifications were rare (2 benign cases). On ultrasound, clear contours were noted in 80% of benign and only in 40% of malignant; unclear - in 60% of malignant. Cystic cavities - in 40% of malignant and 10% of benign. Heterogeneity of the structure was found in 78% of malignant tumors. At the same time, some malignant tumors looked clearly defined, which complicates diagnosis. Conclusion. OFTs are more common in women aged 28-45; malignant and borderline are large. Radiological differentiation from fibroadenoma is difficult. Mammography reveals high density in most benign and a third of malignant cases; calcifications are rare. On ultrasound, malignant variants are often heterogeneous, with cystic cavities and unclear contours, but may also have smooth outlines. Reliable diagnostics are possible only on the basis of biopsy results.

About the authors

References