Case Report


A rare case of a large breast phyllodes tumor

,  ,  ,  ,  

1 MD, Resident of General Surgery in the General Surgery Department of Hospital de Santa Lúzia Portugal

2 MD, Resident of General Surgery in the General Surgery Department of Hospital de Santa Lúzia Portugal

3 MD, Breast Surgeon Department of Breast Surgery, in the Hospital de Santa Lúzia Portugal

4 MD, Director of the General Surgery Service in the Hospital de Santa Lúzia Portugal

5 MD, Director of the Department of Breast Surgery in the Hospital de Santa Lúzia Portugal

Address correspondence to:

Manuel Alexandre Viana Ferreira

Rua António De Mariz, nº22, 4715-279 Braga,

Portugal

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Article ID: 100956Z01MF2018

doi: 10.5348/100956Z01MF2018CR

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How to cite this article

Ferreira MAV, Leite M, Ferreira S, Midões A, Gonçalves A. A rare case of a large breast phyllodes tumor. Int J Case Rep Images 2018;9:100956Z01MF2018.

ABSTRACT


Introduction: Phyllodes tumor is a rare form of breast cancer, and the malignant form, the rarest presentation. Although the Phyllodes tumors rarely metastasizes, they can grow faster than any other breast tumor. Diagnosis and treatment are crucial, and surgery is the first line of action. Large tumors represent a surgical challenge because the excision with free margins is essential to prevent local recurrence and metastatic spread. In this presentation, we report a rare case of a giant Phyllodes tumor weighing 7.15 kg on a 66-year-old woman and a review of the literature highlighting some issues surrounding the management of phyllodes tumors.

Case Report: A 66-year-old women, without known relevant precedents, was admitted to breast pathology consult due a large, ulcerated and infected tumor. An incisional biopsy revealed borderline Phyllodes tumor. No distant metastasis were identified. After infection control, a left mastectomy was performed, with primary closure of the defect by mobilizing the skin flaps. The postoperative period was uneventful. Pathological examination revealed a 30x28x18 cm, 7150 gr malignant Phyllodes tumor with free margins. After one year follow-up there is no evidence of local or distant recurrence. The patient refused plastic reconstructive surgery.

Conclusion: Phyllodes tumor is a rare breast tumor, with the malignant phenotype being the rarest of them all. Surgical therapy is the gold standard for the treatment of phyllodes tumors. Phyllodes tumors should be removed with, at least, 1 cm free margins, especially if they’re malignant tumors. The role of adjuvant therapy is still controversial.

Keywords: Breast cancer, Fibroepithelial neoplasm, Phyllodes tumor

SUPPORTING INFORMATION


Author Contributions:

Manuel Alexandre Viana Ferreira - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published

Mariana Leite - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published

Sandra Ferreira - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published

Alberto Midões - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published

Ana Gonçalves - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published

Guaranter of Submission

The corresponding author is the guarantor of submission.

Source Of Support

None

Consent Statement

Written informed consent was obtained from the patient for publication of this case report.

Data Availability

All relevant data are within the paper and its Supporting Information files.

Conflict of Interest

Authors declare no conflict of interest.

Copyright

© 2018 Manuel Alexandre Viana Ferreira et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.


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