Answer : [FONT=&]cystosarcoma phyllodes aka phyllodes tumor Related Self Assessment Question that will answer the 2nd part [/FONT] Incisional biopsy of a breast mass in a 35-year-old woman demonstrates cystosarcoma phyllodes at the time of frozen section. Which of the following is the most appropriate management strategy for this lesion? A. Wide local excision with a rim of normal tissue B. Lumpectomy and axillary lymphadenectomy C. Modified radical mastectomy D. Excision and postoperative radiotherapy E. Excision, postoperative radiotherapy, and systemic chemotherapy EXPLANATION: Cystosarcoma phyllodes is a tumor most often seen in younger women. It can grow to enormous size and at times ulcerate through the skin. Still, it is a lesion with low propensity toward metastasis. Local recurrence is common, especially if the initial resection was inadequate. Simple reexcision with adequate margins is curative. Very large lesions may necessitate simple mastectomy to achieve clear margins. Axillary lymphadenectomy, however, is seldom indicated without biopsy-positive demonstration of tumor in the nodes. The low incidence of metastatic disease suggests that adjunctive therapy is indicated only for known metastatic disease, even when the tumors are quite large and ulcerated. The answer is A.
