Phyllodes tumors are breast tumors accounting for about 1% of all breast neoplasms in women and are rare in males. Reported here is a case of a 45-year-old male presenting with a rapidly enlarging right breast mass with invasion of the anterior chest wall. Core Needle Biopsy revealed Malignant Phyllodes Tumor. He underwent wide excision and chest wall resection. Reconstruction was performed using polyropelene mesh, a latissimus dorsi flap and split thickness skin grafting. Patient was discharged on the 33rd post-operative day due to delayed expansion of the right lung from splinting and subsequent near-complete loss of the split thickness skin graft over the latissimus muscle flap. On the recommendation of the plastic surgeon, the wound was allowed to heal by secondary intention. This report draws attention to the rarity of malignant phyllodes tumor in males, and the difficulty of recognizing a malignant pathology in males presenting with breast mass. It also highlights a cost-effective treatment option in the management of these tumors.
Malignant Phyllodes tumor ; breast

Purpose: Although adjuvant chemotherapy (CTx) is still recommended for high-risk patients with hormone receptorpositive and human epidermal receptor (HER)-2-negative breast cancer, recent studies found that selected patients with low disease burden may be spared from CTx and receive hormonal treatment (HT) alone. This study aims to evaluate the trends of treatment (CTx + HT vs. HT alone) in Korea and to assess the impact on overall survival (OS) according to treatment pattern. Methods: The Korean Breast Cancer Society Registry was queried (2000 to 2018) for women with pT1-2N0-1 hormone receptor-positive and HER2-negative disease who underwent surgery and adjuvant systemic treatment (CTx and HT). Clinicopathologic factors, change in pattern of treatment over time, and OS for each treatment option were analyzed. Results: A total of 40,938 women were included in the study; 20,880 (51.0%) received CTx + HT, while 20,058 (49.0%) received HT only. In recent years, there has been a steady increase in the use of HT alone, from 21.0% (2000) to 64.6% (2018). In Cox regression analysis, age, type of breast and axillary operations, T and N stages, body mass index, histologic grade,and presence of lymphovascular invasion were prognostic indicators for OS. There was no significant difference between CTx + HT and HT alone in terms of OS (P = 0.126). Conclusion Over the years, there has been a shift from CTx + HT to HT alone without a significant difference in OS. Therefore, HT alone could be a safe treatment option in selected patients, even those with T2N1 disease.

Methods: Using the key words "surgery stage IV breast cancer", a PubMed search for all related articles published in the English language, between January 1999 to December 2009, was done. Of 292 articles yielded by the search, 25 articles focused on the impact of surgery in stage IV breast cancer. Full texts of these of these articles were then collated for this review. Results: No randomized controlled trials comparing the outcome of surgery versus no surgery in metastatic breast cancer have been published thus far. The search yielded only heterogenous data from several retrospective studies for which no systematic reviews or meta-analysis had been done. A summary of these retrospective data was done and reported herein. The reports are grouped into two: those based on population registries, and those coming from single institutions.
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Rationale/Background: Colorectal cancer (CRC) in younger patients is usually considered as having a poorer prognosis compared to the population. Other authors report conflicting results, stating similar or no difference in prognosis. Clearly, age as a prognostic factor in CRC is not yet settled.

Objectives: To determine the relative frequency of CRC in patients 39 years old and below in five major hospitals in Cebu City, and to compare their respective Clinicopathologic features with patients aged 40 years and above.

Study Design: Cross-sectional comparative study.

Method: A chart review of colorectal cancer patients from five tertiary hospitals in Cebu City from January 1999 to December 2003 was the basis of the study. The patients were divided into two age groups (39 years old and below, 40 years old and above). The two groups were compared as to age, gender, family history, duration of disease, site distribution of lesions, tumor grade and histologic subtype.

Results: A total of 408 patients were included in the study. Sixty-one patients were below 40 years old for a frequency of 15 percent. A statistically significant number of CRC patients younger than 40 years old had right-sided lesions and poorly differentiated histopathology.

Conclusion: In this study population, a significant number of colorectal cancers in patients younger than 40 years old have Clinicopathologic features that are different from those in older patients, i.e., they tend to be located at the right side of the colon and have a poorly differentiated histopathology. (Author)

Colorectal Neoplasms ; ; Colon ; ; Multicenter Studies

A retrospective record review of the clinical characteristics and management of primary soft tissue sarcomas in patients admitted to the surgical department of a government hospital, from January 1991 to December 2000, was done. A total of 54 cases were studied. Data showed that patients had a mean age of 45 years with an equal sex distribution. Forty two percent of sarcomas affected the lower limbs. Thirty-three percent of all cases were fibrosarcomas, and most were more than 5 cm in size and situated deep in to the fascial layer. Twenty patients (37 percent) had distant metastases on admission, 45 percent of which involved the lungs. Wide excision was the most common surgical procedure during the last three years of the study period, with less patients refusing surgery than previous years when amputation was the usual treatment. Wide excision resulted in complete gross tumor extirpation in 94 percent of cases. However, after discharge, most patients did not return for follow-up nor complied with the prescribed adjuvant treatments. (Author)

Human ; Middle Aged ; Sarcoma ; Fibrosarcoma ; Amputation ; Sex Distribution ; Lower Extremity

We reviewed the results of 25 small-incision cholecystectomies and 79 conventional cholecystectomies performed at Visayas Community Medical Center from January 1, 2000 to January 31, 2002. There were no differences in the mean age and the male to female ratio in both groups. The mean duration of operation for the small-incision cholecystectomy group was 132.2 minutes while it took 133.4 minutes in the conventional cholecystectomy group. Resumption of regular diet in the small-incision cholecystectomy group was 2.5 days while it took 4 days in the conventional cholecystectomy group. Postoperative hospital stay ranged from 3 to 6 days with a mean of 4 days in the small-incision cholecystectomy group. On the other hand, postoperative hospital stay ranged from 4 to 10 days with a mean of 7.3 days in the conventional cholecystectomy group. Complications seen included postoperative fever, intraoperative bleeding, wound infection and bile leak. Overall, our study confirmed the earlier resumption to regular diet and shorter postoperative stay, thus, faster recovery in the small-incision cholecystectomy group. However, no conclusion can be made because of limitations in the study design and the small sample size. (Author)

Human ; Male ; Female ; Aged ; Middle Aged ; Adult ; Sample Size ; Length Of Stay ; Bile ; Cholecystectomy ; Surgical Wound ; Hemorrhage ; Diet ; Wound Infection