Phyllodes tumour

Case contributed by Dr Amr Farouk

Presentation

Right breast lump of 1 year duration.

Patient Data

Age: 45-50 years
Gender: Female
Mammography

Right breast

Heterogeneously dense breast parenchyma (ACR c). A large encapsulated circumscribed mixed mainly isodense lesion is seen at the right lower central region.

Ultrasound

Right breast US

A large well-defined oval shaped hypoechoic lesion is seen extending from the right 5 -8 o'clock measuring about 6 x 3 cm along its maximum dimensions showing mild cystic changes. 

Case Discussion

Well circumscribed large breast mass with the differential diagnosis including giant fibroadenoma and a phyllodes tumour.

Patient`s older age with rapid progressive clinical course together with mammographic findings of well-circumscribed high-density mass and sonographic findings of heterogeneous internal echogenicity, the presence of cystic components and posterior enhancement favours the diagnosis of phyllodes tumour.

Right breast mass WLE histology

Cut sections showing whitish pink material with a focal reddish area (1.5x1.5 cm) and a cyst 0.5x0.5 cm in diameter.

Microscopy shows cellular stroma with increased cellularity in some areas, entangling scattered mature ducts with pushing border. No evidence of tumour necrosis, cytologic atypia, invasive margin, heteroglous elements. Focal fibro-adenomatous and fibrocystic changes are observed. Safety margin is free of tumour extension. Ki67 labelling index revealed positivity in about 10% of stromal cells, thus the case is consistent with Phyllodes tumour.

Final diagnosis phyllodes tumour.

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Case information

rID: 55418
Case created: 5th Sep 2017
Last edited: 7th Sep 2017
Systems: Breast, Oncology
Inclusion in quiz mode: Included
Institution: Baheya center for early detection & treatment of women’s cancer,Egypt

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