Two cases of malignant phyllodes tumor diagnosed of aspiration cytology.

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Background: Phyllodes tumor is a rare type of fibroepithelial tumor accounting for 0.3-0.5% of breast tumors. We present the cytologic features of phyllodes tumors, these features enabled preoperative diagnoses to be made. Cases: Two women (46 and 44 years old) presented with a tumor mass in the B area of their breasts and were admitted to hospital. Smears showed discohesive cells with abundant cytoplasm predominating. The tumor cells had hyperchromatic round or oval nuclei containing prominent nucleoli. These cells appeared to be pleomorphic and varied in size. Scattered atypical, multinuclear giant cells were also observed. The cytologic preparation contained normal epithelial cells and some foamy cells in the background. The specimens were differentiated from stromal sarcoma, carcinosarcoma, and spindle cell carcinoma based on the absence of malignant epithelial cells and the presence of normal ductal cells and foamy cells in the background. We suspected the tumors to be malignant phyllodes tumors. Conclusion: A wide local excision, with an adequate margin of normal breast tissue, is the preferred initial therapy for phyllodes tumor of the breast, even in malignant cases. Therefore, it is very important to differentiate phyllodes tumor from breast cancer, for which more extensive treatments are required.
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