Phyllodes tumor

Case contributed by Dr Ammar Ashraf

Presentation

Lactating mother with left breast mass for 6 months, associated with mild breast pain. No nipple discharge, change in skin color or fever.

Patient Data

Age: 45 years
Gender: Female
Ultrasound

Two well-defined, lobulated benign-looking hypoechoic nodules measuring 2.0 x 1.9 cm and 1.5 x 1.3 cm, lying close to each other, are seen at 2 o'clock position in the left breast. Mild internal vascularity is seen in the larger nodule on color Doppler ultrasound examination. 

Impression: Well-defined benign looking nodules in a lactating female; possible differentials are fibroadenoma and lactating adenoma.

Mammography

A well-defined lobulated opacity with smooth margins is seen in the upper outer quadrant of the left breast. No architectural distortion, pleomorphic microcalcification clusters, abnormal skin thickening, nipple retraction or significant axillary lymphadenopathy is seen.  

Case Discussion

Procedure: Left breast lumpectomy. 

Gross description: Specimen submitted in one formalin container, labeled "left breast lump" consists of firm, lobulated and encapsulated contiguous nodules measuring 4 x 1.5 x 3 cm.  The larger nodule measures 3 cm and the smaller nodule measures 1.5 cm in diameter.  At the cut section, the larger nodule shows lobulated and encapsulated white cut surface. The smaller nodule shows identical features at the cut sections.

Diagnosis: Phyllodes tumor, low grade.   

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