Phyllodes tumour

Case contributed by Dr Giorgio M Baratelli

Presentation

A firm, well circumscribed and mobile lesion of 2 cm is palpable in the retroareolar region of the left breast of a 34 years old patient. No axillary lymphadenopathy are observed. The lump is noticed for 10 years. The ultrasound images, performed 10 years ago, showed a round homogeneous hypoechoic mass of 1 cm, and at that time the diagnosis of a breast fibroadenoma was made. The patient no longer made ultrasounds or clinical examinations. She came to visit for bilateral mastalgia.

Patient Data

Age: 35-year-old
Gender: Female
Ultrasound

The latest ultrasound shows a lobulated solid and cystic lesion with well defined margins and posterior acoustic enhancement.

Pathology

Solid-cyst breast mass

Case Discussion

The mixed and vascular pattern of the lesion points to a diagnosis of phyllodes tumor  and indicate surgical excision.

Mammography is not performed for the young age of the patient and for the benign aspect of the lesion; similarly core biopsy or FNAC  was not performed  because the lesion shows a benign aspect but the working diagnosis suggests its surgical excision.

A wide surgical excision is performed and the final histopathology report confirm the diagnosis of benign phyllodes tumor.

Conclusion

On breast ultrasound, the sonographic characteristics between fibroadenoma and phyllodes tumors are commonly overlapping; but the heterogeneous pattern (or the presence of cystic spaces inside a hypoechoic lesion) and the vascular pattern can be helpful to suggest the diagnosis of phyllodes  tumor.

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Case information

rID: 28868
Case created: 18th Apr 2014
Last edited: 16th Mar 2017
System: Breast
Inclusion in quiz mode: Included

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