Analysis of patients with phyllodes tumor of the breast.

OBJECTIVE: The diagnosis and management of phyllodes tumors is challenging due to its low incidence. The treatment of these tumors is surgery, however the extent of surgery, the application of adjuvant chemotherapy and radiotherapy are still controversial. Therefore, we aimed to evaluate patients who were treated with a diagnosis of phyllodes tumor of the breast in our clinic. MATERIAL AND METHODS: Patients who were treated with a diagnosis of phyllodes tumor of the breast between June 2011 and June 2013 were reviewed retrospectively. Patient demographic characteristics (age, gender), menopausal status, symptoms, radiologic and surgical methods used for diagnosis and treatment, histopathologic features of the tumor and type of adjuvant therapy were evaluated. Patients were grouped as benign or borderline/malignant according to histopathological diagnosis. Patients in these groups were compared in terms of age, menopausal status, tumor size and the number of mitosis within the tumor. RESULTS: The median age was 26 years (17-59), and 30 patients were female. The surgical treatment of choice was wide local excision with tumor-free surgical margins in 29 patients and mastectomy in one patient. Histopathological diagnosis after surgery was benign in 21 patients (70%), borderline in 6 patients (20%) and malignant phyllodes tumor in 3 patients (10%). Patients with borderline and malignant phyllodes tumors were significantly older (p=0.002) and had higher mitotic counts (p<0.0001). There was no significant relationship between histopathologic subtypes of phyllodes tumors and menopausal status (p=0.06) or tumor size (p=0.1). CONCLUSION: Surgery is the treatment of choice for phyllodes tumors, and obtaining tumor-free margins is important. Since phyllodes tumors might recur as borderline/malignant tumors, local control with surgery and adjuvant radiotherapy should be provided when required. In this way, distant metastases and death that may arise due to possible malignant recurrences might be avoided.

First report of a case with needle track sinus after aspiration biopsy of a benign thyroid nodule resulted in an unexpected postoperative complication.

Fine needle aspiration biopsy is the most feasible, safe, and accurate diagnostic tool for thyroid nodule diagnosis. The development of a sinus tract between thyroid gland and the skin through needle tract after fine needle aspiration biopsy is an extremely uncommon phenomenon. In this paper, a 71-year-old man presenting with a swelling and discharge on the anterior neck wall was reported. Similar complaints were present 15 to 20 days after fine needle aspiration biopsy of thyroid gland four years ago. Bilateral total thyroidectomy was performed considering a thyroid malignancy infiltrating the skin. Histopathologic examination confirmed a sinus tract between the thyroid gland and skin and thyroid nodule was benign in nature. It must be kept in mind that inflammatory reactions might also occur after fine needle aspiration biopsy of benign thyroid nodules. In patients with needle biopsy-related inflammation, surgery may be delayed until the inflammation subsides.