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A case of malignant phyllodes tumor that responded to pazopanib and developed pneumothorax

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Abstract

Here, we present a 59-year-old female with recurrent malignant phyllodes tumor with multiple lung and lymph node metastases who developed a pneumothorax after the administration of pazopanib. The patient received pazopanib as the second-line chemotherapy. After 2.5 months of the therapy, computed tomography (CT) showed a decrease in the sizes and cavitation of lung lesions; however, a left pneumothorax was newly observed. It was difficult to distinguish the pneumothorax by upright chest X-ray. Typical symptom or physical finding of pneumothorax, such as dyspnea, chest pain or decreased breath sound was not observed. As the pneumothorax was small and asymptomatic, the administration of pazopanib was discontinued and follow-up chest X-ray and CT were performed. After 1 week, CT showed an improvement in the pneumothorax. Chemotherapy was switched to eribulin; however, a rapid increase in sizes of lung lesions was observed after the first administration of eribulin, pazopanib was reintroduced. Careful follow-up by chest X-ray and CT was performed and the pneumothorax has not recurred.

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References

  1. Zhang Y, Kleer CG (2016) Phyllodes tumor of the breast: histopathologic features, differential diagnosis, and molecular/genetic updates. Arch Pathol Lab Med 140:665–671

    Article  Google Scholar 

  2. IARC (2019) Publication of the WHO classification of tumours, 5th edition, Volume 2: breast tumours. Available online: https://www.iarc.fr/news-events/who-classification-of-tumours-5th-edition-volume-2-breast-tumours/. Accessed Jun 2022

  3. Tan BY, Acs G, Apple SK et al (2016) Phyllodes tumours of the breast: a consensus review. Histopathology 68:5–21

    Article  Google Scholar 

  4. Rowell MD, Perry RR, Hsiu JG et al (1993) Phyllodes tumors. Am J Surg 165:376–379

    Article  CAS  Google Scholar 

  5. Kapiris I, Nasiri N, Healy V et al (2001) Outcome and predictive factors of local recurrence and distant metastases following primary surgical treatment of high-grade malignant phyllodes tumours of the breast. Eur J Surg Oncol 27:723–730

    Article  CAS  Google Scholar 

  6. Palassini E, Mir O, Grignani G et al (2022) Systemic treatment in advanced phyllodes tumor of the breast: a multi-institutional European retrospective case-series analyses. Breast Cancer Res Treat 192:603–610

    Article  CAS  Google Scholar 

  7. Fede ÂBS, Pereira Souza R, Doi M et al (2021) Malignant phyllodes tumor of the breast: a practice review. Clin Pract 11:205–215

    Article  Google Scholar 

  8. de Roos WK, Kaye P, Dent DM (1999) Factors leading to local recurrence or death after surgical resection of phyllodes tumours of the breast. Br J Surg 86:396–399

    Article  Google Scholar 

  9. Abdalla HM, Sakr MA (2006) Predictive factors of local recurrence and survival following primary surgical treatment of phyllodes tumors of the breast. J Egypt Natl Canc Inst 18:125–133

    Google Scholar 

  10. Parkes A, Wang WL, Patel S et al (2021) Outcomes of systemic therapy in metastatic phyllodes tumor of the breast. Breast Cancer Res Treat 186:871–882

    Article  CAS  Google Scholar 

  11. van der Graaf WT, Blay J-Y, Chawla SP et al (2012) Pazopanib for metastatic soft-tissue sarcoma (PALETTE): a randomised, double-blind, placebo-controlled phase 3 trial. Lancet 379:1879–1886

    Article  Google Scholar 

  12. Landrum MJ, Lee JM, Benson M et al (2016) ClinVar: public archive of interpretations of clinically relevant variants. Nucleic Acids Res 44:D862–D868

    Article  CAS  Google Scholar 

  13. Tate JG, Bamford S, Jubb HC et al (2019) COSMIC: the catalogue of somatic mutations in cancer. Nucleic Acids Res 47:D941–D947

    Article  CAS  Google Scholar 

  14. Kobayashi E, Naito Y, Asano N et al (2019) Interim results of a real-world observational study of eribulin in soft tissue sarcoma including rare subtypes. Jpn J Clin Oncol 49:938–946

    Article  Google Scholar 

  15. Wu H, Li L, Yang J et al (2020) Radiotherapy with apatinib for recurrence of malignant phyllodes tumor of the breast: a case report. Medicine (Baltimore) 99:e18808

    Article  Google Scholar 

  16. Kyriazoglou A, Zagouri F, Dimopoulos MA (2019) Olaratumab administered in two cases of phyllodes tumour of the breast: end of the beginning? ESMO Open 4:e000479

    Article  Google Scholar 

  17. Koukourakis IM, Zygogianni A, Kouloulias V et al (2021) Successful treatment of a locally recurrent and metastatic malignant phyllodes tumor with accelerated radiotherapy and nab-paclitaxel, cisplatin, and liposomal doxorubicin chemotherapy. Chemotherapy 66:82–86

    Article  CAS  Google Scholar 

  18. Liu SY, Joseph NM, Ravindranathan A et al (2016) Genomic profiling of malignant phyllodes tumors reveals aberrations in FGFR1 and PI-3 kinase/RAS signaling pathways and provides insights into intratumoral heterogeneity. Mod Pathol 29:1012–1027

    Article  CAS  Google Scholar 

  19. Bollag G, Clapp DW, Shih S et al (1996) Loss of NF1 results in activation of the Ras signaling pathway and leads to aberrant growth in haematopoietic cells. Nat Genet 12:144–148

    Article  CAS  Google Scholar 

  20. Lapinski PE, Kwon S, Lubeck BA et al (2012) RASA1 maintains the lymphatic vasculature in a quiescent functional state in mice. J Clin Invest 122:733–747

    Article  CAS  Google Scholar 

  21. Hoag JB, Sherman M, Fasihuddin Q, Lund ME (2010) A comprehensive review of spontaneous pneumothorax complicating sarcoma. Chest 138:510–518

    Article  Google Scholar 

  22. Nakano K, Motoi N, Tomomatsu J et al (2016) Risk factors for pneumothorax in advanced and/or metastatic soft tissue sarcoma patients during pazopanib treatment: a single-institute analysis. BMC Cancer 16:750

    Article  Google Scholar 

  23. Calvetti L, Aprile G (2019) Influence and mechanism of lung cavitation development on antiangiogenic therapy: is cavitation the new caveat? Transl Lung Cancer Res 8:319–322

    Article  CAS  Google Scholar 

  24. Caswell DR, Swanton C (2017) The role of tumour heterogeneity and clonal cooperativity in metastasis, immune evasion and clinical outcome. BMC Med 15:133

    Article  Google Scholar 

  25. Aiba H, Kimura H, Yamada S et al (2021) Different patterns of pneumothorax in patients with soft tissue tumors treated with pazopanib: a case series analysis. PLoS ONE 16:e0254866

    Article  CAS  Google Scholar 

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Acknowledgements

The authors are grateful to the patient for participating in this case report.

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Correspondence to Hirofumi Ohmura.

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Ohmura, H., Masuda, T., Mimori, K. et al. A case of malignant phyllodes tumor that responded to pazopanib and developed pneumothorax. Int Canc Conf J 12, 31–35 (2023). https://doi.org/10.1007/s13691-022-00572-9

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  • DOI: https://doi.org/10.1007/s13691-022-00572-9

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