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358 Contralateral recurrent phyllodes tumor of the vulva in a teenager
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  1. GA Polaquini1,
  2. J Minari Bozko2,
  3. CL Minari3,4,
  4. A Estremadoiro Vargas3,
  5. JE Jung5,
  6. R Bernardini de Lima5,
  7. JC Linhares3,4 and
  8. A Tsunoda3,4
  1. 1Hospital Erasto Gaertner, Cirurgia Oncologica, Curitiba, Brazil
  2. 2Universidade de Riberão Preto, Faculdade de Medicina, Riberão Preto, Brazil
  3. 3Hospital Erasto Gaertner, Ginecologia oncologica, Curitiba, Brazil
  4. 4Instituto de Oncologia do Paraná, Ginecologia Oncologica, Curitiba, Brazil
  5. 5Hospital Erasto Gaertner, Patologia, Curitiba, Brazil

Abstract

Objectives Phyllodes tumor of the vulva is a rare condition, potentially arising from extra-mammary glands or mammary-like tissue, with less than 20 cases described in the literature. Patients from 17yo to 69yo usually present a painless tumor, with no other symptoms. Surgical complete removal is the current mainstain therapy.

Objetive To describe the diagnostic and therapeutic management of a Phyllodes tumor of the vulva occuring in a 15 year old female.

Methods The patient presented a pedunculated vulvar mass on the left labia majora, with 8 cm in the largest diameter. CT scans suggested a localized non invasive tumor. A margin free local resection was performed. Pathology report was conclusive for a Phyllodes tumor, with positive estrogen and progesterone receptors, cytokeratin AE1/AE3, and alpha smooth-muscle actin. Ki-67 index was 1%. Two years later, she recurred in the contralateral labia majora, with two pedunculated lesions (2 cm and 1.5 cm). A surgical resection was proposed, with perioperative frozen-section analysis of the margins.

Results Final pathology reports revealed a new diagnosis of Phyllodes tumor of the vulva, with free margins. There was a partial surgical site dehiscence, successfully managed conservatively. The patient is free of disease 8 months after last surgical resection.

Conclusions In this case report, an extremelly rare condition was diagnosed in a very young patient, with a contralateral recurrence, unusual for this type of tumor. Management was succesfull, with free margins local resections.

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