The phyllodes bundu ibundu risingawanzoitiki rezamu, rinowanzoonekwa kare kupfuura kenza yemazamu. Kazhinji kazhinji ine hutsinye, asi hukasha mafomu akashata aripo. Mushonga waunosarudza kuvhiyiwa, une fungidziro yakanaka, kunyangwe kana kudzokorora kwenzvimbo kusingagoni kubviswa.

tsananguro

Phyllodes bundu ibundu risingawanzoitiki rezamu, iro rinotanga mune connective tissue. Ibundu rakasanganiswa, rinodaidzwa kuti fibroepithelial, rinoratidzirwa nekuwanda kwemasero epithelial uye masero anobatana, nepo ruzhinji rwegomarara rezamu rinokanganisa masero egland. 

Phyllodes tumors inowira mumapoka matatu:

• ruzhinji (pakati pe50% uye 75% maererano nevanyori) mamota asina kunaka (giredhi 1)
• 15-20% ndiwo mapundu emuganhu, kana borderline (giredhi 2)
• 10 kusvika 30% mamota akaipa, kureva kenza (giredhi 3), dzimwe nguva inonzi phyllodes sarcomas.

Giredhi 1 phyllodes tumors inowedzera zvishoma nezvishoma uye inowanzova duku (yekurongeka kwemasentimita), inokurumidza kukura uye yakakura phyllodes tumors (kusvika ku 15 cm) inowanzova yakaipa.

Chete yakaipa phyllodes tumors inogona kukonzera metastases.

Zvinokonzera

Zvikonzero zvekuumbwa kwemamota aya zvinoramba zvisinganzwisisike.

chirwere

Bundu racho, iro rinoumba hukuru hwakanyatsotsanangurwa hunyoro, rinowanzoonekwa panguva yekuzviongorora kana kuongororwa kwekiriniki mukubvunzana kwevakadzi.

Kukurumidza kukura kwehuwandu hunozivikanwa huripo hunogona kuratidza kuongororwa, zvakare kutungamirirwa nezera remurwere.

MAPOSTER

Miedzo yekufungidzira inosarudzwa ndeye mammography uye ultrasound, asi MRI inogona kupa ruzivo mune zvimwe zviitiko. Nekudaro, bvunzo idzi hadziwanzo kuita kuti zvikwanise kuongorora giredhi rebundu re phyllodes, kana kurisiyanisa nefibradenoma, bundu rezamu rakafanana.

biopsy

Percutaneous biopsy (kutora zvimedu zvenyama uchishandisa tsono inopinzwa mukati meganda) inoitwa pasi pekutungamirirwa kwe ultrasound. Iyo inobvumira histological verification: matishu anotorwa anoongororwa pasi pemaikorosikopu kuti aone chimiro chebundu.

Vanhu vane hanya

Mamota ePhyllodes anogona kuitika chero zera asi anonyanya kubata vakadzi vari pakati pemakore makumi matatu nemashanu nemakumi mashanu ekuzvarwa, uye chiitiko chepamusoro chiri pakati pemakore makumi mana nemakumi mana nemashanu. Ivo saka vanoonekwa gare gare kupfuura fibradenoma, iyo inobata vakadzi vadiki zvakanyanya, asi pamberi pegomarara rezamu.

Ivo vanomiririra isingasviki 0,5% yemamota ese emazamu.

Zvinhu zvinotyisa

Vatsvagiri vanofungidzira kupindira kwezvakasiyana genetic predisposing zvinhu mukuonekwa uye kukura kwemamota aya.

Mamota mazhinji e phyllodes haarwadze uye haabatanidzwe neaxillary lymphadenopathy (hapana anofungira, akaoma kana anopisa lymph nodes muhapwa).

Pa palpation iyo nodule yakasimba, inofamba kana iri diki, inonamatira kumatissue kana ichikura.

Mamota makuru anogona kuperekedzwa nemaronda eganda. Kashoma, pane kubuda muzamu kana kudzosa zamu.

sejari

Kurapa kunonyanya kuenderana nekuvhiyiwa kwemamota asiri-metastatic, angave akaipa kana akaipa, asi uchichengetedza muganho wekuchengetedza we1 cm. Kuvhiyiwa kwekuchengetedza kuri kuramba kuchidiwa pane mastectomy. Izvi zvingave zvakadaro zvakakosha kana pakaitika zvehukasha.

Axillary lymph node dissection haiwanzo kubatsira.

Radiotherapy

Radiotherapy inogona kuumba adjuvant kurapwa kweanokuvadza phyllodes tumors, kunyanya kana chiitiko chekudzokazve.

Kurapwa

Kubatsira kwechemotherapy seadjuvant kurapwa kweakaipa phyllodes tumors inokurukurwa pane imwe nyaya-ne-case hwaro. Maprotocol anoshandiswa akafanana neaya anoiswa mukurapwa kwemasarcomas akapfava.

Kuzivikanwa kwemamota efillodes kunowanzova kwakanaka, pasina kudzokororwa pamakore gumi muvakadzi vasere pagumi, zvisinei negiredhi rebundu racho. 

Kudzokororwa kwomunzvimbomo, zvisinei, kunoramba kuri kazhinji kazhinji. Zvinonyanya kuitika mukati memakore maviri ekuvhiyiwa, asi zvinogona kuoneka gare gare, izvo zvinoda kugara uchitariswa. Mamota akaipa anowanzo dzoka kare.

Bundu re phyllodes rinodzoka rinogona kunge richinyanya hutsinye muzvisikwa kupfuura bundu rekutanga. Zvizhinji kashoma, pane zvinopesana, zvichava nehunhu hwakanyanya kunaka. Mamwe mazamu ane benign anogona saka kudzoka muchimiro chegomarara regomarara, kana kunyangwe metastatic evolution. Ngozi yemetastasizing yakakura kana iyo yekutanga phyllodes bundu yaive yakaipa.

Muchiitiko chekudzokazve kwenzvimbo, iyo inonzi "catch-up" mastectomy inopa kurapa kwepamusoro asi inoramba iri chiito chekucheka, chinowanzova chakaipa nevakadzi vachiri vaduku. Kubatsirwa kweradiotherapy uye / kana chemotherapy inokurukurwa pane imwe nyaya-ne-kesi hwaro neboka rehutano.

Kufanotaura kunoramba kuine hurombo kana kudzokorora kwehasha kunotungamirira pakuonekwa kwemasastases. Mhinduro kune chemotherapy haiwanzogara, uye rufu runoitika mukati me4 kusvika kumwedzi mitanhatu. Kuongorora nokudaro kune basa rakakosha rekuita.