Recurrent Giant Malignant Phyllodes Tumor of the Breast

Abstract

Phyllodes tumors (PTs) are rare fibroepithelial neoplasms of the breast. They have a proliferating stromal component that can be graded as benign, borderline, and malignant. In addition, they are associated with an increased risk of local recurrence and distant metastasis. The authors hereby present a case report of a 34-year-old woman with recurrent malignant PT with an increasing aggressiveness. There were two recurrences of giant tumors that consumed the entire right breast, which developed over a three-year period. The final surgical treatment was a total extirpation of the tumor with subsequent plastic reconstruction using a cutaneous flap from the region of the latissimus dorsi muscle. The patient died three months after the last recurrence due to multiorgan failure.

Giant Phyllodes Tumor in an 82-Year-Old Female Initially Diagnosed a Fibroadenoma: A Case Report

“…The ambiguity in surgical guidelines makes it difficult for the physician to decide the extent of resection for the tumor to best prevent local recurrence and avoid the need for another operation. The rate of local recurrence for benign phyllodes tumors after excision with negative margins is 8% compared to 20% for borderline or malignant phyllodes tumors [7,10]. Recurrences tend to occur within the first two years after excision [7,10].…”

“…The rate of local recurrence for benign phyllodes tumors after excision with negative margins is 8% compared to 20% for borderline or malignant phyllodes tumors [7,10]. Recurrences tend to occur within the first two years after excision [7,10]. The use of adjuvant radiotherapy has been recommended to minimize local recurrence in borderline and malignant phyllodes tumors [4,7,10].…”

“…Phyllodes tumors and fibroadenomas are both included in the category of biphasic fibroepithelial lesions of the breast; fibroadenomas are far more common in clinical practice and constitute the majority of benign breast masses in younger women [2,[7][8][9]. Phyllodes tumors can be categorized histologically as either benign, borderline, or malignant based on the degree of stromal proliferation [6,7,10]. Benign phyllodes tumors have an increased degree of stromal cellularity with mild to moderate cellular atypia, borderline ones demonstrate a greater degree of stromal cellularity and cellular atypia, and malignant ones demonstrate marked stromal cellularity and atypia [6,7,10].…”

“…Phyllodes tumors can be categorized histologically as either benign, borderline, or malignant based on the degree of stromal proliferation [6,7,10]. Benign phyllodes tumors have an increased degree of stromal cellularity with mild to moderate cellular atypia, borderline ones demonstrate a greater degree of stromal cellularity and cellular atypia, and malignant ones demonstrate marked stromal cellularity and atypia [6,7,10]. The majority of phyllodes tumors are classified as benign variants [6,7,10].…”

“…Benign phyllodes tumors have an increased degree of stromal cellularity with mild to moderate cellular atypia, borderline ones demonstrate a greater degree of stromal cellularity and cellular atypia, and malignant ones demonstrate marked stromal cellularity and atypia [6,7,10]. The majority of phyllodes tumors are classified as benign variants [6,7,10]. The stromal architecture is described histologically as displaying an intracanalicular growth pattern with leaf-like stromal processes that can be demonstrated on core biopsy of the lesion [2].…”