{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T21:21:24Z","timestamp":1792790484901,"version":"4.5.0"},"reference-count":27,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T00:00:00Z","timestamp":1784764800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82160582"],"award-info":[{"award-number":["82160582"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:p>Malignant phyllodes tumors (MPTs) of the breast account for approximately 8% to 20% of all phyllodes tumors (PTs) and represent a rare but clinically significant subtype of breast malignancy. Diagnosis is based on the histologic criteria of increased stromal cellularity, stromal overgrowth, cytologic atypia, elevated mitotic activity, and infiltrative tumor margins. MPTs may be associated with malignant heterologous elements, although most tumors exhibit a single component. The coexistence of two or more heterologous components is extremely rare. Herein, we report a case of malignant phyllodes tumor in a 60-year-old female, characterized by heterologous components of osteosarcoma and pleomorphic liposarcoma. We detail the treatment and outcomes, and present a literature review summarizing cases with two or more heterologous elements. This study aims to expand clinical understanding, elucidate the prognostic significance of heterologous component types, and inform the diagnosis and treatment of this rare entity.<\/jats:p>","DOI":"10.3389\/fonc.2026.1897827","type":"journal-article","created":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T04:28:33Z","timestamp":1784780913000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Malignant phyllodes tumor of the breast with heterologous osteosarcomatous and pleomorphic liposarcomatous differentiation: a rare case report and literature review"],"prefix":"10.3389","volume":"16","author":[{"given":"Mengxia","family":"Deng","sequence":"first","affiliation":[{"name":"College of Clinical Medicine, Dali University","place":["Dali, Yunnan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xingwang","family":"Lu","sequence":"additional","affiliation":[{"name":"College of Clinical Medicine, Dali University","place":["Dali, Yunnan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhuangting","family":"Wang","sequence":"additional","affiliation":[{"name":"College of Clinical Medicine, Dali University","place":["Dali, Yunnan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhengjin","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Pathology, The First Affiliated Hospital of Dali University","place":["Dali, Yunnan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lixian","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Pathology, The First Affiliated Hospital of Dali University","place":["Dali, Yunnan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pengqiao","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Pathology, The First Affiliated Hospital of Dali University","place":["Dali, Yunnan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bo","family":"Gao","sequence":"additional","affiliation":[{"name":"College of Clinical Medicine, Dali University","place":["Dali, Yunnan, China"]},{"name":"Department of Pathology, The First Affiliated Hospital of Dali University","place":["Dali, Yunnan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,23]]},"reference":[{"key":"B1","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":"B2","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2024.1372710","article-title":"Malignant phyllodes tumor of the breast with predominant osteosarcoma and chondrosarcomatous differentiation: a rare case report and review of literature","volume":"14","author":"Li","year":"2024","journal-title":"Front Oncol"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1111\/his.15455","article-title":"Malignant phyllodes tumours of the breast: the case for revising WHO's 'full house' diagnostic criteria","volume":"87","author":"Tan","year":"2025","journal-title":"Histopathology"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1111\/his.14091","article-title":"The 2019 World Health Organization classification of tumours of the breast","volume":"77","author":"Tan","year":"2020","journal-title":"Histopathology"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.3390\/clinpract11020030","article-title":"Malignant Phyllodes Tumor of the Breast: A Practice Review","volume":"11","author":"Fede","year":"2021","journal-title":"Clin Pract"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1016\/j.radcr.2023.02.039","article-title":"Malignant phyllodes tumor of the breast with heterologous osteosarcoma and chondrosarcomatous differentiation: a rare case report with imaging findings","volume":"18","author":"Ko","year":"2023","journal-title":"Radiol Case Rep"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1111\/his.14397","article-title":"Diagnostic concordance of phyllodes tumour of the breast","volume":"79","author":"Rakha","year":"2021","journal-title":"Histopathology"},{"key":"B8","unstructured":"Protocol for the examination of resection specimens from patients with phyllodes tumor of the breast (Version 1.1.0.1)\n          \n          \n          \n          2022"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1097\/PAS.0000000000002109","article-title":"Comprehensive Clinical-Pathologic Assessment of Malignant Phyllodes Tumors: Proposing Refined Diagnostic Criteria","volume":"47","author":"Turashvili","year":"2023","journal-title":"Am J Surg Pathol"},{"key":"B10","article-title":"Malignant phyllodes tumor with heterologous osteosarcomatous and rhabdomyosarcomatous elements: a case report and literature review","volume":"53","author":"Ali","year":"2023","journal-title":"Ann Clin Lab Sci"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1111\/tbj.13555","article-title":"Phyllodes tumor with osteosarcomatous differentiation should be followed closely: an unusual case","volume":"26","author":"Berkesoglu","year":"2020","journal-title":"Breast J"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0463.2007.apm_588.x","article-title":"Malignant phyllodes tumor with associated osteosarcomatous, chondrosarcomatous, and liposarcomatous overgrowth","volume":"115","author":"Tomas","year":"2007","journal-title":"APMIS"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000018808","article-title":"Radiotherapy with apatinib for recurrence of Malignant phyllodes tumor of the breast: a case report","volume":"99","author":"Wu","year":"2020","journal-title":"Med (Baltimore)"},{"key":"B14","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1016\/s0960-7404(03)00005-7","article-title":"Malignant phyllodes tumor of the breast: review of the literature and case report of stromal overgrowth","volume":"12","author":"Guerrero","year":"2003","journal-title":"Surg Oncol"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijscr.2015.02.009","article-title":"Phyllodes tumour with heterologous sarcomatous differentiation: case series with literature review","volume":"11","author":"Warrier","year":"2015","journal-title":"Int J Surg Case Rep"},{"key":"B16","doi-asserted-by":"publisher","first-page":"651","DOI":"10.4103\/0973-1482.137996","article-title":"Malignant phyllodes tumor with heterologous differentiation: a rare case report","volume":"11","author":"Patil Okaly","year":"2015","journal-title":"J Cancer Res Ther"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2023.1141353","article-title":"Case report: Osteosarcomatous differentiation in the lung metastasis of a malignant phyllodes tumor","volume":"10","author":"Liu","year":"2023","journal-title":"Front Med"},{"key":"B18","doi-asserted-by":"publisher","first-page":"62","DOI":"10.1016\/j.breast.2021.03.001","article-title":"Retrospective study of malignant phyllodes tumors of the breast: Younger age, prior fibroadenoma surgery, malignant heterologous elements and surgical margins may predict recurrence","volume":"57","author":"Li","year":"2021","journal-title":"Breast"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1016\/j.prp.2021.153489","article-title":"Molecular characterization of pleomorphic liposarcomatous differentiation in Malignant phyllodes tumor of the breast: a case report","volume":"224","author":"Zhou","year":"2021","journal-title":"Pathol Res Pract"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1038\/modpathol.2016.97","article-title":"Genomic profiling of malignant phyllodes tumors reveals aberrations in FGFR1 and PI-3 kinase\/RAS signaling pathways and provides insights into intratumoral heterogeneity","volume":"29","author":"Liu","year":"2016","journal-title":"Mod Pathol"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1177\/030089160609200414","article-title":"Phyllodes tumor with osteosarcomatous differentiation: a comparative immunohistochemical study between epithelial and mesenchymal cells","volume":"92","author":"Ribeiro-Silva","year":"2006","journal-title":"Tumori"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1242\/dev.146589","article-title":"Wnt signaling in development and tissue homeostasis","volume":"145","author":"Steinhart","year":"2018","journal-title":"Development"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1016\/j.surge.2022.01.004","article-title":"Diagnosis and management of phyllodes tumours for the surgeon: An algorithm","volume":"20","author":"Ofri","year":"2022","journal-title":"Surgeon"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1007\/s13193-022-01525-7","article-title":"Malignant phyllodes tumor with heterologous sarcomatous differentiation: a case series and review of literature","volume":"13","author":"Atram","year":"2022","journal-title":"Indian J Surg Oncol"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1136\/esmoopen-2020-000843","article-title":"Prognostic factors in phyllodes tumours of the breast: retrospective study on 166 consecutive cases","volume":"5","author":"Di Liso","year":"2020","journal-title":"ESMO Open"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.5306\/wjco.v6.i5.174","article-title":"Liposarcoma of the breast arising in a malignant phyllodes tumor: A case report and review of the literature","volume":"6","author":"Banys-Paluchowski","year":"2015","journal-title":"World J Clin Oncol"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000027908","article-title":"Breast osteosarcoma originating from a Malignant phyllodes tumor: a case report of a rare neoplasm","volume":"100","author":"Jin","year":"2021","journal-title":"Med (Baltimore)"}],"container-title":["Frontiers in Oncology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2026.1897827\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T04:28:35Z","timestamp":1784780915000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2026.1897827\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,23]]},"references-count":27,"alternative-id":["10.3389\/fonc.2026.1897827"],"URL":"https:\/\/doi.org\/10.3389\/fonc.2026.1897827","relation":{},"ISSN":["2234-943X"],"issn-type":[{"value":"2234-943X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,23]]},"article-number":"1897827"}}