Human Pathology
Volume 41, Issue 2 , Pages 293-296, February 2010

Invasive ductal breast cancer within a malignant phyllodes tumor: case report and assessment of clonality

  • Stephan Macher-Goeppinger, MD

      Affiliations

    • Institute of Pathology, Heidelberg University, 69120 Heidelberg, Germany
    • ,
  • Frederik Marme, MD

      Affiliations

    • Department of Gynaecology and Obstetrics, Heidelberg University, 69120 Heidelberg, Germany
    • ,
  • Benjamin Goeppert, MD

      Affiliations

    • Institute of Pathology, Heidelberg University, 69120 Heidelberg, Germany
    • ,
  • Roland Penzel, Phd

      Affiliations

    • Institute of Pathology, Heidelberg University, 69120 Heidelberg, Germany
    • ,
  • Peter Schirmacher, MD

      Affiliations

    • Institute of Pathology, Heidelberg University, 69120 Heidelberg, Germany
    • ,
  • Hans Peter Sinn, MD

      Affiliations

    • Institute of Pathology, Heidelberg University, 69120 Heidelberg, Germany
    • ,
  • Sebastian Aulmann, MD

      Affiliations

    • Institute of Pathology, Heidelberg University, 69120 Heidelberg, Germany
    • Corresponding Author InformationCorresponding author.

Received 17 April 2009; received in revised form 29 July 2009; accepted 7 August 2009. published online 09 November 2009.

Summary 

Invasive carcinomas arising within fibroepithelial tumors represent an uncommon manifestation of breast cancer. We report the case of a 70-year-old woman who underwent mastectomy for a malignant phyllodes tumor measuring 6 cm. Histological workup of the specimen revealed a high-grade invasive ductal carcinoma 2.5 cm in diameter within the phyllodes tumor. DNA was isolated from microdissected epithelial and stromal components of the phyllodes tumor as well as from the invasive ductal carcinoma cells. Using multiplex polymerase chain reaction, a comparative allelotyping was performed with a panel of 11 microsatellite markers. The malignant stroma of the phyllodes tumor showed loss of heterozygosity at chromosome 16q23, 17q12, 17q25, and 22q13; the epithelial tumor component shared the loss of 16q23; whereas the invasive carcinoma had lost divergent alleles at 16q23, 17q12, and 17q25, indicating a lack of clonality between phyllodes tumor and invasive ductal carcinoma. Although our data are compatible with a previously postulated common origin of epithelial and stromal components of phyllodes tumors, the coexisting invasive ductal carcinoma appears to represent a true collision tumor.

Keywords: Phyllodes tumor, Breast cancer, Clonality, Loss of heterozygosity

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PII: S0046-8177(09)00291-3

doi:10.1016/j.humpath.2009.08.006

Human Pathology
Volume 41, Issue 2 , Pages 293-296, February 2010

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