Prostate
Other malignancies
Phyllodes variant of STUMP

Authors: Kenneth A. Iczkowski, M.D. (see Authors page)

Revised: 31 October 2017, last major update October 2017

Copyright: (c) 2003-2017, PathologyOutlines.com, Inc.

PubMed Search: prostatic phyllodes
Cite this page: Iczkowski, K.A. Phyllodes variant of STUMP. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/prostatephyllodes.html. Accessed December 18th, 2017.
Definition / general
  • Variant or subtype of stromal tumor of uncertain malignant potential (STUMP)
  • < 100 reported cases
  • Tumor with cellular or sarcomatoid stroma and hyperplastic glands
  • Resembles breast tumor
  • Usually recurs after transurethral prostatic resection
Essential features
Epidemiology
  • Age range 25 to 86 years (mean 55)
Sites
Clinical features
  • Urinary obstructive symptoms and hematuria
  • Recurrence seen in 7 of 14 low grade tumors (50%) (J Urol 2004;172:894)
    • Metastases to abdominal wall in one patient 11 years after initial diagnosis, following 3 recurrences
    • 22 year old man had lung metastasis
Laboratory
Prognostic factors
  • Histological grading is predictive of short term outcome based on the combination of stromal cellularity, cytological atypia, number of mitotic figures (> 5 mitotic figures / 10 HPF) and the stroma to epithelium ratio (J Urol 2004;172:894)
Case reports
Treatment
  • Usually radical prostatectomy alone
  • One patient had a temporary response to radiotherapy and chemotherapy before death (Can Urol Assoc J 2014;8:E263)
  • Inoperable case managed by palliative treatment using luteinizing hormone releasing hormone analogue (BMJ Case Rep 2010 Dec 1;2010)
Gross description
  • Multiple cystic and solid areas
Gross images
Images hosted on other servers:

Multiple solid and cystic areas

Microscopic (histologic) images
Images hosted on PathOut server:

Images contributed by Kenneth A. Iczkowski, M.D.

Low power

High power



Images hosted on other servers:

Pseudopapillary structures with cleft-like spaces

Various images

Positive stains
Molecular / cytogenetics description
Differential diagnosis
Board review question #1
Phyllodes variant of STUMP:

  1. Has a stromal component that is positive for broad spectrum keratin
  2. Has grossly solid growth pattern
  3. If low grade, will rarely recur
  4. Is clinically malignant and metastasizes in most cases
  5. May present with markedly elevated PSA
Board review answer #1
E. May present with markedly elevated PSA

  1. Stromal component is keratin negative
  2. Has cystic spaces and may be mostly cystic
  3. Recurrence is quite common regardless of grade
  4. Most cases are clinically benign and metastasis is rare