Cystosarcoma Phyllodes Mammae, Fibrosarcoma Variant
A. H. ROBNETT, M.D.
Department of Surgery
JOHN B. HAZARD, M.D.
Department of Pathology
R. S. DINSMORE, M.D.
Division of Surgery
THE term cystosarcoma phyllodes, originating more than a century ago is attributed to Johannes Muller who, in 1838, utilized it “to designate the cauliflower-like masses of connective tissue which fill a cystic cavity in the breast.”1 In 1941 Owens and Adams2 listed thirty different names for the same lesion, and agreed with other authors that a more appropriate term was giant intracanalicular fibroadenoma of the breast.
Confusion regarding the exact nature of the lesion still exists, principally in relation to actual or potential malignancy; i. e. whether it is basically sarcomatous or benign. Although cases reported have emphasized that the lesion is benign in a vast majority of instances, ultimately lethal sarcoma has been noted also. In 1950 Steckler and Landman3 found in the literature 3 reported cases of cystosarcoma phyllodes with metastases and described a fourth of their own. Saltzstein and Pollack4 stated in 1949 that, in a review of 52 cases of cystosarcoma phyllodes, Pollack found 8 to be cancerous. McDonald and Harrington5 protested the use of the term cystosarcoma phyllodes, believing that 90 per cent of the lesions so termed are benign and the other 10 per cent are fibrosarcoma. They agree with and quote Deaver’s statement that “Large tumors of intracanalicular myxomatous type are not sarcomas and the term cystosarcoma should be abandoned.”5
The following case report illustrates the accepted clinical and pathologic characteristics of cystosarcoma phyllodes with areas of fibrosarcoma in the stroma.
Three years prior to examination the patient, a nulliparous white. . .