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      Fibromatose desmoïde du sein: à propos d'un cas et une revue de la literature Translated title: Desmoid fibromatosis of the breast: a case report on and a review of the literature

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          Abstract

          La fibromatose desmoïde mammaire est une entité rare, mimant sur le plan clinique et échographique un cancer du sein. Seule l'histologie apportera le diagnostic en objectivant une prolifération de cellule fusiforme (fibro et myofibroblastique sans atypies nucléaires), agencée en faisceaux, mêlés à des bandes de collagène, sans composante épithéliale. Le diagnostic différentiel se pose essentiellement avec le carcinome métaplasique à cellules fusiformes. L’évolution est strictement locale, avec un grand pouvoir récidivant. L'exérèse chirurgicale complète avec des marges saines (jusqu’à 3cm) est le traitement de choix, la radiothérapie reste une option thérapeutique en complément de la chirurgie dans les exérèses incomplètes et en cas de récidives multiples. A travers notre cas et une revue de la littérature, nous essayerons de mettre le point sur le diagnostic de cette entité rare et de sa prise en charge puisqu'elle va conditionner le pronostic.

          Most cited references15

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          The desmoid syndrome. New aspects in the cause, pathogenesis and treatment of the desmoid tumor.

          Based on a detailed clinical and laboratory investigation of 89 patients with histologically verified desmoid tumor and the pertinent medical literature, we have reviewed the etiologic factors, clinical characteristics, and results of treatment of this rare disorder. The incidence of the tumor in the Finnish population is low, 2.4 to 4.3 new cases per 10(6) inhabitants per year. The age distribution profile demonstrated four distinct peak periods: the juvenile period, the fertile period, the middle-age period and the old-age period. The juvenile desmoid tumor is an extraabdominal tumor found in young girls, the fertile variety is an abdominal tumor found in women, the middle age variety is also overwhelmingly abdominal but the sex ratio approaches equality, whereas in the old age group, both abdominal and extraabdominal tumors are equally frequent and the sex ratio is equal. In all male patients, the growth rate was low. A low growth rate was also recorded in young girls. A growth rate of twice that speed was seen in fertile women and four times that speed in the middle age group. In the old age group, a low growth rate, equal to that of male patients, was a rule. The fertile female patients with desmoid tumor had a significant predisposition to estrogen dominance and deviation from progesterone dominance. The direct relationship of the growth rate to the level of endogenous estrogen in the female patients and the demonstration of significant amounts of estradiol but not progesterone receptors in the tumor cytosol further suggest that the growth rate of desmoid tumor is regulated by steroid sex hormones. A significant number of patients with an abdominal desmoid tumor had a history of surgical trauma in the region of subsequent tumor growth. A very high number of the patients demonstrated multiple minor malformations of the bony skeleton. An increased frequency of these malformations was also recorded in the families of the patients and the distribution of the malformations among the family members was compatible with an autosomally dominant pattern of inheritance. After operation, the frequency of recurrence was not statistically different, regardless of whether the tumor was completely removed or not. A combination of operation and radiotherapy did not reduce the frequency of recurrences; in fact, it doubled it.(ABSTRACT TRUNCATED AT 400 WORDS)
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            Recent developments in the histological diagnosis of spindle cell carcinoma, fibromatosis and phyllodes tumour of the breast.

            Norman Lee (2007)
            This article reviews recent advances in the diagnosis of these three unusual tumours of the breast. Spindle cell carcinoma needs to be considered in the differential diagnosis of many mammary spindle cell lesions: it is important to be aware of the wide range of appearances, including the recently described fibromatosis-like variant. Immunohistochemistry using a broad panel of cytokeratin antibodies is needed to exclude spindle cell carcinoma; there is frequent expression of basal cytokeratins and p63. CD34 is often expressed by the stroma of phyllodes tumours, but does not appear to be expressed by spindle cell carcinoma or fibromatosis. Nuclear beta-catenin is found in about 80% of fibromatoses, but can also be seen in spindle cell carcinomas and phyllodes tumours. Two recent studies have described features useful in the distinction of phyllodes tumour and fibroadenoma on core biopsy, including increased cellularity, mitoses and overgrowth of the stroma, adipose tissue in the stroma and fragmentation of the biopsy specimen. Periductal stromal tumour is a recently described biphasic tumour composed of spindle cells around open tubules or ducts (but no leaf-like architecture) with frequent CD34 expression. The overlap of morphology with phyllodes tumour suggests that it may be best regarded as a variant of phyllodes tumour.
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              Desmoid tumors (fibromatoses) of the breast: a 25-year experience.

              Breast desmoid tumors are rare and often clinically mistaken for carcinoma. We reviewed our 25-year institutional experience with breast desmoid tumors.
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                Author and article information

                Journal
                Pan Afr Med J
                Pan Afr Med J
                PAMJ
                The Pan African Medical Journal
                The African Field Epidemiology Network
                1937-8688
                03 June 2015
                2015
                : 21
                : 88
                Affiliations
                [1 ]Université Sidi Mohammed Benabdellah, Service de Gynécologie-Obstétrique 2, CHU Hassan II de Fès, Maroc
                Author notes
                [& ]Corresponding author: Sarah Amourak, Service de Gynéco-Obstétrique 2, CHU Hassan II, Fès, Maroc
                Article
                PAMJ-21-88
                10.11604/pamj.2015.21.88.7124
                4594983
                26491531
                ccb4ed03-c3e5-4eb4-8bac-2d1015f0b3ba
                © Sarah Amourak et al.

                The Pan African Medical Journal - ISSN 1937-8688. This is an Open Access article distributed under the terms of the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 20 May 2015
                : 03 June 2015
                Categories
                Case Report

                Medicine
                fibromatose desmoide,sein,récidive,marge saine,desmoid fibromatosis,relapse,healthy margin
                Medicine
                fibromatose desmoide, sein, récidive, marge saine, desmoid fibromatosis, relapse, healthy margin

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