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Complete Pathologic Response Following Multimodality Therapy for a Recurrent, High-Grade Phyllodes Tumor

Nadia Ashai, Saranya Chumsri, Dina Kokh, Olga Ioffe, Zeljko Vujaskovic, Steven Feigenberg, Katherine Tkaczuk, Susan Beth Kesmodel

Abstract


Introduction: Phyllodes tumor is a rare mesenchymal tumor of the breast for which surgical resection is the primary therapy. Despite adequate surgical resection, local recurrence rates of up to 40% are observed in patients with high-grade tumors. The role of adjuvant radiation therapy and chemotherapy for phyllodes tumor to improve local and systemic control is not well established. However, several small studies have shown improvements in local control rates with adjuvant radiation therapy. The management of aggressive local phyllodes tumor recurrences can be a clinical challenge and multimodality therapy should be considered in these cases for optimal results.

Case presentation: We present the case of a high-grade phyllodes tumor that recurred in the radiation field after adjuvant radiation therapy. The patient was treated with neoadjuvant hyperfractionated, accelerated radiotherapy in combination with hyperthermia and chemotherapy followed by radical surgical resection. A completed pathologic response was observed.

Conclusion: This multimodality approach may be a successful treatment algorithm for high-grade tumors that reoccur in a prior radiation field.


Keywords


Phyllodes tumor; hyperfractionated accelerated radiotherapy; hyperthermia; sarcoma

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References


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