Phyllodes tumour is a rare breast tumour with potential of malignancy. Recurrence in phyllodes tumour may also be suggestive of malignant transformation. We report a case of 29-year-old woman with recurrent phyllodes tumour infiltrating the latissimus dorsi reconstruction flap. Re-excision of the tumour along with excision of latissimus dorsi flap was done. Histopathology confirmed malignant phyllode tumour. A significantly higher incidence of recurrence is seen in phyllodes tumour of large size, tumours with infiltrative borders, increased mitotic activity, malignant histology and positive margins. Surgeons should always take into consideration the risk factors for recurrence before planning reconstructive breast surgery in recurrent phyllodes tumour. A preoperative MRI imaging and incisional biopsy are essential in planning surgery for these patients.
Lung cancers usually present very late with distant metastasis, thereby carrying a poor prognosis. Metastasis at unusual sites such as extremity musculature does create a diagnostic challenge. This leads to delay in diagnosis and treatment initiation and further worsens the prognosis of the patient. Not many cases have been reported as of now and no standard guidelines are available regarding clinical approach in such cases. We have presented one of such cases to emphasize on importance of early detection and differentiation of such lesions from primary soft tissue malignancies.
We present a case of an exceptionally large size non-functioning pancreatic neuroendocrine tumor (PNET) in a young female. The tumor occupied the whole abdomen and pelvis and was clinically masqueraded as an ovarian tumor. Imaging with contrast enhanced CT scan and magnetic resonance imaging of the abdomen aided in preoperative diagnosis of origin of the tumor from the pancreas. Distal pancreatectomy with splenectomy and left hemicolectomy was done. Primary colocolic anastomosis was done for reconstruction. Postop course was uneventful, and patient was discharged with advice to undergo adjuvant chemotherapy. Surgical excision of large size locally advanced non-functional PNET should be done with curative intention/ to treat symptoms and improve patient survival
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