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Case Report
Larger than life: A case of a bleeding giant phyllodes tumor in a COVID-19 positive patient
1 Surgical Oncology Fellow, Section of Surgical Oncology, Department of Surgery, Rizal Medical Center, Pasig City, National Capital Region, Philippines
2 Chairperson, Department of Surgery, Rizal Medical Center, Pasig City, National Capital Region, Philippines; University of the Philippines College of Medicine Manila, Manila, National Capital Region, Philippines
3 Program Director, Section of Surgical Oncology, Department of Surgery, Rizal Medical Center, Pasig City, National Capital Region, Philippines
4 Residentin-Training, Department of Surgery, Rizal Medical Center, Pasig City, National Capital Region, Philippines, Philippines
Address correspondence to:
Louie Czelline L De Leon
MD, Rizal Medical Center, Pasig Boulevard, Pasig City, National Capital Region,
Philippines
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Article ID: 101480Z01LL2024
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De Leon LCL, Bisquera Jr OC, Sarmiento RI, Ramirez D. Larger than life: A case of a bleeding giant phyllodes tumor in a COVID-19 positive patient. Int J Case Rep Images 2024;15(2):103–110.ABSTRACT
Introduction: Phyllodes tumor of the breast, also known as cystosarcoma phyllodes, is a rare fibroepithelial tumor that accounts for about 0.3–1% of all breast tumors. Unlike most breast tumors that start from the ducts and gland, phyllodes tumor originates from the stroma. The classification of phyllodes tumor is less important on assessing the risk of recurrence as compared to the presence of tumor-free margins after surgical treatment.
Case Report: A 54-year-old female presented at the emergency room with a large, bleeding, left breast mass. The patient tested positive for COVID-19 and was admitted previously at the isolation ward. After medical management of her current condition, the patient underwent wide excision (total mastectomy), left with en bloc resection of pectoralis major with delayed reconstruction via split thickness skin graft. This case is one of the few reported giant phyllodes tumor in the English literature, measuring 30 cm widest dimension.
Conclusion: Malignant phyllodes tumor is a rare form of breast malignancy behaving like a sarcoma. A diagnostic dilemma may be encountered in patients with such tumors due to the rarity of these cases and the different presentation of the tumor. High suspicion shall be entertained for patients with breast masses which tend to appear like benign lesions but with sudden enlargement. Adequate surgical intervention shall be done ensuring tumor-free margins. Adjuvant therapy for malignant phyllodes tumor is still controversial but shall be entertained according to the patient’s actual case needs.
Keywords: Bleeding, COVID-19, Giant, Malignant phyllodes tumor
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Author Contributions
Louie Czelline L De Leon - 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
Orlino C Bisquera Jr - Substantial contributions to conception and design, Acquisition of data, Interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Ray I Sarmiento - Interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Danielle Ramirez - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Final approval of the version to be published
Guarantor of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2024 Louie Czelline L De Leon 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.
