Das maligne Cystosarcoma phylloides stellt die bösartige Variante des Fibroadenoms der Mamma dar. Trotz Epithelatypien hängt das biologische Verhalten von der malignen Transformation des dominierenden mesenchymalen Tumorstromas ab. Das oft stark variierende histologische Bild entspricht meistens einem Fibrosarkom. Lipoblastische, chondroide und myxoide Strukturen oder Ossifikationen können auftreten, völlig entdifferenzierte Zystosarkome sind selten. Die eingeschlossenen, typischerweise kanalikulären Epithelstrukturen können hyperplastische und dysplastische Veränderungen sowie apokrine Umwandlung, gelegentlich auch Plattenepithelmetaplasien aufweisen. Neben dem aggressiven lokalen Wachstum sind hämatogene Metastasen in das Skelettsystem und in die Lungen häufig. Die Therapie ist von der lokalen Ausdehnung und von den Metastasen abhängig: radikale Mastektomie mit Lymphadenektomie und postoperative Radiotherapie. Lokalrezidive sind bei mehr als 50% der Fälle zu erwarten, die Mortalitätsrate beträgt nach 5 Jahren etwa 30%.

Keywords:
Cystosarcoma phylloides, Malignität, Metastasiemng, Mesenchyma-les Stroma, Sarkomatöse Transformation
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© 1984 S. Karger AG, Basel
1984
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