Malignant phyllodes tumor of the breast

Case contributed by Dr Mohammadtaghi Niknejad

Presentation

Large right breast palpable mass on physical exam.

Patient Data

Age: 45 years
Gender: Female
mammography

Huge mass with lobulated margin and internal coarse calcification foci in the right breast, involving most parts of the breast.

Small benign-looking mass with well-defined smooth margin, without internal calcification or surrounding parenchymal distortion, in the lower inner quadrant of the breast.

Case Discussion

The patient underwent an ultrasound guided multiple core needle biopsy, and then wide local excision was performed on the mass. Histopathology evaluation and IHC confirmed phyllodes tumor with malignant transformation.

Phyllodes (cystosarcoma phyllodes) tumor is a rare fibroepithelial tumor, and patients typically present with a painless, rapidly growing breast mass. Malignant transformation accounts for up to a quarter of the phyllodes tumors. A tumor diameter of 3 cm or greater has been generally reported to be associated with a higher likelihood of malignancy.

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