Malignant phyllodes tumor of the breast with rapid progression: a case report

Disseminated malignant phyllodes: Presentation after a decade

Phyllodes tumors are rare biphasic fibroepithelial lesions of the breast and account for 0.3%-0.5% of primary breast tumors. Malignant phyllodes tumor has a 10%-26% risk of distant metastasis. The most common site of metastasis is lungs followed by bone and soft tissue. This is a rare case of a 42-year-old female with a previous history of malignant phyllodes tumor breast. She presented after 10 years with metastases to multiple sites including lung, abdominal wall, retroperitoneum, bone, and brain. These tumors have a poor overall survival. Accurate diagnosis and aggressive management of malignant phyllodes tumors can help in effective treatment at diagnosis and for close follow-up of the patients.

A Rare Case of the Malignant Phyllodes Breast Tumor - Case Report

The phyllodes tumor (cystosarcoma phyllodes) is a rare fibroepithelial neoplasm presenting less than 1% of all breast tumors. Based on histologic features World Health Organization (WHO) classifies into benign, border line and malignant tumors (the rarest). Only around 5-15% of all malignant form cases metastasize hematogeneosly in the lung, bone and brain. Clinically are mostly presented the phyllodes tumor mostly presents as a rapid growth, palpabile, painless, elastic, oval or lobulated masses over 5 cm among women between 40 to 50 years old. On ultrasound and mammography these tumors usually resembles other round or oval benign lesions, mostly like fibroadenomas. These tumors on ultrasound and mammography usually resembles other round or oval benign tumors, mostly like fibroadenomas. Ultrasound guided core needle biopsiy (CNB) performed under ultrasound is a gold standard for palpabile breast masses. Surgical resection remains the gold standard of treatment. To date, there is no consensus regarding the recommendations for radiotherapy, hormonal therapy and systemic chemotherapy. We present the case of 30 years old woman, who noted a painless mass in her left breast, which was gradually increasing in size. Clinical, ultrasound and magnetic resonance examination confirmed the existence of tumor formation without the possibility of making an accurate diagnosis. Malignant phyllodes tumor was initially diagnosed by core biopsy. The patient underwent a radical modified mastectomy and postoperative radiotherapy. During the follow-up for the first 11 months, our patient has been feeling well without signs of local recurrence and metastasis. The aim of our case is to emphasize the importance of early diagnosis and treatment of this rare breast tumor.

Treatment is based on the size and the extent of the mass with surgical resection and adequate margins extremely important in successful outcome. We present the case of 30 old woman, who noted a painless mass in her left breast, which was gradually increasing in size. She was diagnosed with ultrasound and magnetic resonance imaging and the diagnosis of the malignant phyllodes tumor was confirmed by patohistological verification.

Metastatic Phyllodes Tumor in a Patient With Beckwith-Wiedemann Syndrome

Beckwith-Wiedemann syndrome (BWS) is an epigenetic disorder of imprinting on the chromosome 11p15 region that presents with clinical features, such as macroglossia, abdominal wall defects, neonatal hypoglycemia, hemihypertrophy, and embryonal tumors. Phyllodes tumors (PTs) are rare fibroepithelial tumors that account for 0.3% to 1% of breast tumors and present in women aged 35 to 55 years. Here we describe a rare case of metastatic malignant phyllodes tumor in a 27-year-old woman with BWS and uniparental disomy (UPD) of chromosome 11p15.5. To our knowledge, this is the first case report in literature to describe metastatic malignant phyllodes tumor in a woman with BWS.

Malignant phyllodes tumor of the breast with metastases to the lungs: A case report and literature review

Phyllodes tumors (PTs) are rare fibroepithelial neoplasms of the breasts. Approximately 10%-15% of PTs are malignant, and 9%-27% of patients with malignant PTs, develop metastatic disease. The lungs are the most common target organ for distant metastasis of PT. We report a case of 44-year-old female with a malignant PT. It had recurred locally 3 times, and 3 relapses occurred 13 months after the first diagnosis, presenting multiple metastases to the lungs by CT scan. The patient underwent radiation therapy, and palliative chemotherapy with doxorubicin was initiated. Two courses of doxorubicin therapy were administered, but the patient expired 16 months after PT diagnosis. We present a rare case of malignant PT with local recurrences, lung metastases, and poor patient outcome. Although malignant breast PTs have an unfavorable prognosis, adjuvant radiotherapy combined with margin-negative resection may be associated with decreased local recurrence and distant metastasis rates. Future research should include randomized clinical trials or well-designed prospective matched studies to clarify the effectiveness of treatments of PTs.

The Defect Repair After a Giant Malignant Phyllodes Tumor Resection of Breast Using a Kiss Flap

Malignant phyllodes tumors of the breast are fairly rare and fast-growing tumors. They are not sensitive to chemotherapy or hormonal therapy. Therefore, the primary treatment for malignant phyllodes tumors is wide surgical excision. Herein, we report a case study which featured a 26-year-old woman presented with a giant malignant phyllodes tumor measuring 20 × 17 × 13 cm. In order to reduce the chance of local recurrence, treatment for these types of tumors usually involves extensive excision with at least 1 cm of surgical margins. The patient underwent mastectomy with negative surgical margins, which left a large skin defect of 25 × 15 cm. Repair of such a large skin defect is a challenge to breast surgeons. This is the first reported case in which a “kiss” flap was successfully used to repair the skin defect created after resection of a giant malignant phyllodes tumor. The kiss flap could be considered as an effective and simple method to repair large chest wall defects after resection of giant phyllodes tumors.

Large borderline phyllodes breast tumor related to histopathology, diagnosis, and treatment management - case report

Breast phyllodes tumors (PTs) are uncommon tumors with a biphasic fibroepithelial component, characterized by rapid development in middle-aged women. A correct preoperative diagnosis after Tru-Cut biopsy allows for proper surgical planning. The treatment of choice remains surgery (wide local excision or mastectomy) with or without breast reconstruction, depending on the size and histopathological (HP) nature of the tumor. We reported a case of a 50-year-old woman with a large PT in her left breast, measuring 11/10 cm. Preoperative HP examination revealed biphasic proliferation, with the appearance of benign PT. The patient underwent a left mastectomy, with a favorable postoperative evolution. The final HP diagnosis was borderline PT, with areas of lipomatous metaplasia. After three months, breast reconstruction was performed. The therapeutic management of large PTs continues to be a challenge for pathologists and surgeons. Due to the increased frequency of local recurrence and HP progression to malignancies, the treatment of choice for these patients is mastectomy, without lymphadenectomy.

Malignant Phyllodes Breast Tumor: A Rare Case of Metastasis in Skeletal Muscle Detected on 18-Fluorodeoxyglucose Positron Emission Tomography

Rapidly growing cystosarcoma phyllodes tumor (PT) of the breast are rarely encountered. Distant metastases are not uncommon in malignant PTs; however, rare sites of metastases are sometimes observed. Here, we present the case of a rapidly metastasizing malignant PT in which skeletal muscle metastasis was identified on 18F-fluorodeoxyglucose-based positron emission tomography-computed tomography reflecting its aggressive course and poor prognosis.