{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T17:05:28Z","timestamp":1778605528251,"version":"3.51.4"},"reference-count":39,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,4,14]],"date-time":"2025-04-14T00:00:00Z","timestamp":1744588800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:p>Phyllodes tumo (PT) of the breast are classified into benign, borderline, and malignant types. Malignant phyllodes tumor (MPT) with metastasis, particularly those containing sarcomatous components, have a notably poor prognosis. The most common sites of metastasis are the lungs, although metastases can also occur in the pleura and other areas. Metastatic PT is typically treated according to NCCN guidelines for soft tissue sarcomas. The prognosis for patients is extremely poor, with survival typically not exceeding five years. Therefore, the treatment of metastatic MPT presents significant challenges. A 67-year-old female with a history of PT surgery was hospitalized due to acute chest tightness and shortness of breath. MRI revealed a large mass in the left thoracic region, measuring 7.9 \u00d7 10.8 \u00d7 11.4 cm. A biopsy conducted prior to hospitalization indicated spindle cell soft tissue sarcoma. Due to critical vital signs, she underwent an emergency thoracotomy. Postoperative analysis confirmed the diagnosis of thoracic metastasis from MPT with sarcomatous components. Genetic analysis of the tumor tissue post-surgery revealed a KDM6A gene mutation. Unfortunately, subsequent imaging showed a recurring mass in the left thoracic space, approximately 8 cm in size. Considering the side effects of NCCN-recommended treatments (doxorubicin and ifosfamide) and the high cost of targeted therapies, the patient and her family chose tislelizumab. After six cycles of treatment, the patient\u2019s progression-free survival reached 15 weeks. Due to unsatisfactory treatment effects, the patient and her family decided to discontinue therapy, and the patient passed away in July 2024. Although the combination of surgery and postoperative immune checkpoint inhibitors remains to be validated, this case provides valuable insights into the management of thoracic metastasis from MPT. It offers potential new options for personalized immunotherapy in metastatic MPT.<\/jats:p>","DOI":"10.3389\/fonc.2025.1535653","type":"journal-article","created":{"date-parts":[[2025,4,14]],"date-time":"2025-04-14T04:10:52Z","timestamp":1744603852000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Unexpected outcomes of tislelizumab treatment in thoracic metastasis of malignant phyllodes tumors: a case report and literature review"],"prefix":"10.3389","volume":"15","author":[{"given":"Yihao","family":"Liu","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhixuan","family":"Duan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Minghui","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yongwen","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Min","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jun","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Honglin","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,4,14]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.6004\/jnccn.2007.0027","article-title":"Phyllodes tumors of the breast: natural history, diagnosis, and treatment","volume":"5","author":"Telli","year":"2007","journal-title":"J Natl Compr Canc Netw"},{"key":"B2","article-title":"Phyllodes tumors","volume-title":"Diseases of the Breast","author":"Anderson","year":"2004"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-193101000-00034","article-title":"Giant intracanalicular myxoma of the breast:the so-called cystosarcoma phyllodes mammae of Johannes Muller","volume":"93","author":"Lee","year":"1931","journal-title":"Ann Surg"},{"key":"B4","doi-asserted-by":"publisher","first-page":"106969","DOI":"10.1016\/j.ijsu.2022.106969","article-title":"Management of phyllodes tumor: A systematic review and meta-analysis of real-world evidence","volume":"107","author":"Yu","year":"2022","journal-title":"Int J Surg"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19890615)63:12<2532::AID-CNCR2820631229>3.0.CO;2-Q","article-title":"Surgical treatment of phyllodes tumors of the breast","volume":"63","author":"Salvadori","year":"1989","journal-title":"Cancer"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.32074\/1591-951X-754","article-title":"Malignant phyllodes tumor of the breast: a systematic review","volume":"114","author":"Lissidini","year":"2022","journal-title":"Pathologica"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1177\/00031348231198114","article-title":"Metastatic and Malignant phyllodes tumors of the breast: an update for current management","volume":"89","author":"Goodwin","year":"2023","journal-title":"Am Surg"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.10.4948","article-title":"Imaging features of solitary fibrous tumors","volume":"196","author":"Ginat","year":"2011","journal-title":"AJR Am J Roentgenol"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2023.1110997","article-title":"Tislelizumab immunotherapy combined with chemotherapy in the treatment of a patient with primary anterior mediastinal undifferentiated pleomorphic sarcoma with high PD-L1 expression: A case report and literature review","volume":"13","author":"Yang","year":"2023","journal-title":"Front Oncol"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(17)30622-8","article-title":"Gemcitabine and docetaxel versus doxorubicin as first-line treatment in previously untreated advanced unresectable or metastatic soft-tissue sarcomas (GeDDiS): a randomised controlled phase 3 trial","volume":"18","author":"Seddon","year":"2017","journal-title":"Lancet Oncol"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1016\/S1010-7940(02)00099-4","article-title":"Solitary fibrous tumors of the pleura: Clinical characteristics, surgical treatment and outcome","volume":"21","author":"Magdeleinat","year":"2002","journal-title":"Eur J Cardiothorac Surg"},{"key":"B12","doi-asserted-by":"publisher","first-page":"bcr2014207995","DOI":"10.1136\/bcr-2014-207995","article-title":"A common problem in the elderly with an uncommon cause: Hypoglycaemia secondary to the doege-potter syndrome","author":"Tay","year":"2015","journal-title":"BMJ Case Rep"},{"key":"B13","article-title":"Fibroepithelial tumors and hamartomas of the breast","volume-title":"Breast tumors. 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