IntroductionPhyllodes tumors account for less than 1% of breast tumors in women, and giant phyllodes tumors are those that are larger than 10 cm in diameter. Removal of such large tumors places a huge burden on the surgeon to reconstruct a breast that is aesthetically acceptable by the patient. We report what may be the largest giant phyllodes tumor and, most likely, the first latissimus dorsi flap used to cover such a large defect caused by the resection.Case presentationWe report the case of a 36-year-old Malaysian woman who presented with a three-year history of gradually increasing swelling of the left breast, with skin changes. Examination revealed a huge, globular, lobulated mass measuring 400 mm by 350 mm. The patient had a mastectomy with an immediate latissimus dorsi pedicled myocutaneous flap reconstruction. The breast weighed 8.27 kg, and ex vivo, the tumor measured 280 mm by 250 mm by 180 mm. Histopathologic analysis confirmed the diagnosis as a giant phyllodes tumor. At 12-month follow-up, the patient reports no complications and is satisfied with the aesthetic outcome.ConclusionGiant phyllodes tumors are very rare tumors that can reach up to 40 cm in diameter. Reconstruction of such a defect is a great challenge, and we report what we believe is the first latissimus dorsi flap to cover successfully a defect of approximately 400 mm by 350 mm.

No abstract

Dermatofibrosarcoma protuberans (DFSP) is a rare cutaneous neoplasm with a high frequency of recurrence after inadequate primary treatment. It is most commonly seen in individuals in their third to fifth decades but has been reported in all age groups. Literatures regarding Dermatofibrosarcoma protuberans accounts for less than 0.1% of all malignant neoplasms and approximately 1% of all soft tissue sarcomas. The incidence has been estimated to be 0.8 to 5 cases per 1 million people per year. A wide-margin surgical excision with microscopically disease-free margins is the standard treatment. We report two cases of dermatofibrosarcoma protuberans at different sites of the body and present a detailed discussion of the diagnosis, treatment and outcomes with reference to available literatures.

Background: Primary poorly differentiated adenocarcinoma of the accessory breast is rare. We report such a case in a 56-year-old Malaysian woman of Indian ethnicity. Case Presentation: An axillary swelling measuring 5 × 5 cm on excisional biopsy revealed a poorly differentiated adenocarcinoma with positive HER2 gene amplification. Conclusion: Overall prognosis is similar to that of a carcinoma of the normal breast, therefore early diagnosis is imperative to ascertain curable status and improve prognosis.

Intussusception is a common surgical problem among pediatric age group, but the same cannot be said in their adult counterparts. While the disease process is similar in both age groups, the etiopathology and hence the management of this condition differs significantly. In this report, we present a case of an adult female with an ileo-ileal intussusception secondary to a small bowel lipoma, followed by a discussion on the difference of clinical features and management between adults and pediatrics.