Aggressive malignant phyllodes tumor of breast with omental metastases – A case report

2021 ◽  
Vol 40 (4) ◽  
pp. 287-291
Author(s):  
B. Rajkrishna ◽  
Rajesh Balakrishnan ◽  
Mithun Raam ◽  
A. Santhosh Raj ◽  
Patricia Sebastian ◽  
...  
Keyword(s):  
Radical Mastectomy ◽  
Phyllodes Tumor ◽  
Distant Metastases ◽  
Left Breast ◽  
Adjuvant Radiation ◽  
Left Chest ◽  
Dismal Prognosis ◽  
Phyllodes Tumour ◽  
Flap Cover ◽  
Malignant Phyllodes Tumour

Distant metastasis from malignant Phyllodes tumour (PT) is rare. They generally metastasize to the lung, bone, pleura, and liver. We present a very rare case of a 25-year-old woman with intraabdominal metastases from malignant phyllodes tumour of the breast. She presented with left breast lump and the biopsy was Phyllodes tumour. She underwent a two staged surgery; left modified radical mastectomy followed by left latissimus dorsi musculocutaneous flap cover. She received adjuvant radiation therapy to left chest wall. Following which she developed intrabdominal mass which was proven to be metastasis from Phyllodes tumour. She was then advised palliative chemotherapy. Malignant Phyllodes with distant metastases has a dismal prognosis. We propose it is preferable to have a CT Thorax and Abdomen as a staging workup for patients with malignant PT to identify those with poor prognosis.

scholarly journals Secretory breast carcinoma in a female adult with liver metastsis: a case report and literature review

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Jing Lian ◽  
Li-Xia Wang ◽  
Jiang-hong Guo ◽  
Peng Bu ◽  
Yan-feng Xi ◽  
...  
Keyword(s):  
Liver Metastasis ◽  
Breast Carcinoma ◽  
Poor Prognosis ◽  
Hormone Receptors ◽  
Fatal Outcome ◽  
Radical Mastectomy ◽  
Distant Metastases ◽  
Left Breast ◽  
Secretory Breast Carcinoma

Abstract Background Secretory breast carcinoma is an uncommon subset of breast cancer that usually has a favorable outcome. Although initially described in children, it also occurs in adults where it may metastasize, possibly resulting in death. To date, only 20 cases of secretory breast carcinoma with distant metastases have been described. Case presentation A 42-year-old female presented with liver metastasis after modified radical mastectomy of the left breast in 2008 at 34 years of age. The liver metastasis was morphologically similar to the primary tumor. Pan-TRK and Fluorescence in situ hybridization showed a rearrangement in the ETV6 gene. She subsequently underwent adjuvant chemotherapy with a fatal outcome. Conclusions Although secretory breast carcinoma is usually associated with favorable outcomes, our study and reviews provide a novel insight into the genetic spectrum and treatment of secretory breast carcinoma showing reduced expression of hormone receptors, abnormal genomic profiles, and possible poor prognosis. Targeted therapy may curb clinically aggressive cases. Additional molecular investigations are needed to determine the links between specific mutations and poor prognosis.

scholarly journals Giant Malignant Phyllodes Tumour of Breast- A Clinical Dilemma and Surgical Challenge

2021 ◽  
Author(s):  
Raghav Yelamanchi ◽  
Nikhil Gupta ◽  
Dhruv Gupta ◽  
CK Durga
Keyword(s):  
Pectoralis Major Muscle ◽  
Left Breast ◽  
High Index ◽  
Image Guided ◽  
Phyllodes Tumour ◽  
Benign Tumours ◽  
Clinical Dilemma ◽  
Phyllodes Tumours ◽  
High Index Of Suspicion ◽  
Malignant Phyllodes Tumour

Phyllodes tumour is an uncommon tumour of the breast. It is fibroepithelial in origin and mostly benign. Giant phyllodes tumours are described as tumours with size more than 10 cm and are extremely rare. Differentiating malignant and benign tumours pathologically is difficult and needs clinical judgement and high index of suspicion. A 50-year-old female presented with complaint of swelling in the left breast. On further evaluation, it was diagnosed as phyllodes tumour on biopsy. She underwent left mastectomy and excision of pectoralis major muscle due to clinical and radiological suspicion of malignancy. Postoperative histopathology report revealed malignant phyllodes tumour. Cases of giant phyllodes tumour should undergo adequate imaging and image guided biopsy with high index for suspicion for malignancy. They should be operated as per the principles of oncosurgery as there is a high probability of such huge tumours harboring malignancy.

scholarly journals Chimeric ALT Plus TFL Perforator Flap for Breast Reconstruction Post Radical Mastectomy with Large Skin Defect

2021 ◽  
Vol 54 (02) ◽  
pp. 208-210
Author(s):  
Dushyant Jaiswal ◽  
Mayur Raman Mantri ◽  
Vinay Kant Shankhdhar ◽  
Snehjeet Hemant Wagh
Keyword(s):  
Donor Site ◽  
Perforator Flap ◽  
Radical Mastectomy ◽  
Phyllodes Tumor ◽  
Left Breast ◽  
Skin Defect ◽  
Postoperative Radiation Therapy ◽  
Internal Mammary ◽  
Skin Excision ◽  
Large Skin

AbstractA 17-year-old girl with large malignant phyllodes tumor of left breast underwent a radical mastectomy with large skin excision resulting in defect of 20 cm × 18 cm. Postoperative radiation therapy necessitated robust cover with flap. The challenge was compounded by her body habitus. Both abdomen and back were deficient as donor sites and a single-island anterolateral thigh (ALT) flap would need skin grafts, volume deficit withstanding. We harvested chimeric ALT plus tensor fascia lata (TFL) perforator free flap sparing all muscles and nerves. Microvascular anastomoses were done to the second internal mammary artery (IMA) perforator artery and vein. The donor site was closed primarily. The TFL flap territory recruited almost three times the volume of ALT territory and allowed us to create a matching breast mound in addition to covering the defect. She tolerated 40 Gy radiation well and doesn’t desire further augmentation. Consistency of ALT and TFL perforators makes this a replicable procedure.

scholarly journals Fibroadenoma in an operated case of malignant phyllodes tumour: a rare case report

2017 ◽  
Vol 4 (2) ◽  
pp. 792
Author(s):  
Iresh Shetty ◽  
Tushar Jadhav ◽  
Aditya Lad ◽  
Gaurav Batra ◽  
Ishant Rege ◽  
...  
Keyword(s):  
Frozen Section ◽  
Left Breast ◽  
Low Grade ◽  
Previous Surgery ◽  
Rare Presentation ◽  
Phyllodes Tumour ◽  
Rare Case Report ◽  
Single Disease Entity ◽  
Phyllodes Tumours ◽  
Malignant Phyllodes Tumour

Phyllodes tumours are rare fibroepithelial lesions that account for less than 1% of breast neoplasms. Displaying a broad range of clinical and pathological behaviour, phyllodes tumours should be regarded as a spectrum of fibroepithelial neoplasms rather than a single disease entity. We would like to present a rare presentation of fibroadenoma over site of a previously operated case of malignant phyllodes tumour. A 36 year old female came to OPD with complaints of lump in both breasts since 4 months. She gave history of previous surgery, i.e., left breast lumpectomy for which HPE report was suggestive of malignant phyllodes tumour. On examination, 3x2 cm, solitary, firm to hard, non-tender lump was felt in the junction of the upper outer and inner quadrant just below the scar of previous surgery and was not freely mobile and appeared fixed to the scar. Patient underwent excision of the lump with frozen section and final HPE report turning out to be fibroadenoma. Though diagnosis of malignant phyllodes tumour is not difficult, diagnosis of low grade phyllodes tumour and distinction from fibroadenoma on FNA is difficult due to overlapping features between the two lesions. Surgery remains the mainstay of treatment for patients with cystosarcoma phyllodes, extent of surgery been controversial, and continues to evolve. Incidence of fibroadenoma occurring at the previous operated site of malignant phyllodes tumour is very rare with no known previous documentation of such a case.

scholarly journals Bilateral Phyllodes Giant Tumor. A Case Report Analyzed by Array-CGH

Diagnostics ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. 825
Author(s):  
Francesco Fortarezza ◽  
Federica Pezzuto ◽  
Gerardo Cazzato ◽  
Clelia Punzo ◽  
Antonio d’Amati ◽  
...  
Keyword(s):  
Array Cgh ◽  
Phyllodes Tumor ◽  
Molecular Classification ◽  
Left Breast ◽  
Comparative Genomic ◽  
Fish Analysis ◽  
Molecular Tests ◽  
Giant Tumor ◽  
Metastatic Risk ◽  
The Right

The breast phyllodes tumor is a biphasic tumor that accounts for less than of 1% of all breast neoplasms. It is classified as benign, borderline, or malignant, and can mimic benign masses. Some recurrent alterations have been identified. However, a precise molecular classification of these tumors has not yet been established. Herein, we describe a case of a 43-year-old woman that was admitted to the emergency room for a significant bleeding from the breast skin. A voluminous ulcerative mass of the left breast and multiple nodules with micro-calcifications on the right side were detected at a physical examination. A left total mastectomy and a nodulectomy of the right breast was performed. The histological diagnosis of the surgical specimens reported a bilateral giant phyllodes tumor, showing malignant features on the left and borderline characteristics associated with a fibroadenoma on the right. A further molecular analysis was carried out by an array-Comparative Genomic Hybridization (CGH) to characterize copy-number alterations. Many losses were detected in the malignant mass, involving several tumor suppressor genes. These findings could explain the malignant growth and the metastatic risk. In our study, genomic profiling by an array-CGH revealed a greater chromosomal instability in the borderline mass (40 total defects) than in the malignant (19 total defects) giant phyllodes tumor, reflecting the tumor heterogeneity. Should our results be confirmed with more sensitive and specific molecular tests (DNA sequencing and FISH analysis), they could allow a better selection of patients with adverse pathological features, thus optimizing and improving patient’s management.

scholarly journals Malignant Phyllodes Tumor Including Aneurysmal Bone Cyst-Like Areas in Pregnancy - a Case Report and Review of the Literature

Breast Care ◽  
2016 ◽  
Vol 11 (4) ◽  
pp. 291-294 ◽  
Author(s):  
Canan Kelten ◽  
Ceren Boyaci ◽  
Cem Leblebici ◽  
Kemal Behzatoglu ◽  
Didem C. Trabulus ◽  
...  
Keyword(s):  
Case Report ◽  
Bone Cyst ◽  
Clinical Breast Examination ◽  
Phyllodes Tumor ◽  
Breast Cancer Diagnosis ◽  
Left Breast ◽  
Malignant Phyllodes Tumor ◽  
Her Family ◽  
Simple Mastectomy ◽  
Clinical Breast

Background: Malignant phyllodes tumors of the breast are rare biphasic neoplasms. Only few cases related to pregnancy have been reported. Case Report: A 37-year-old woman presented with swelling and pain in her left breast as well as hyperemia on the breast skin, 4 weeks after labor. In her family history, her aunt and maternal cousin had had a breast cancer diagnosis. Clinical evaluation of the patient was consistent with a breast abscess. Therefore, abscess drainage and biopsy from the cavity wall were performed. However, the biopsy was diagnosed as malignant phyllodes tumor. An evaluation by ultrasonography showed a well-defined hypoechoic mass with many cystic spaces covering the entire breast tissue. Therefore, a simple mastectomy was performed. Microscopic examination revealed a high-grade malignant phyllodes tumor. Additionally, bone cyst-like areas in the form of sponge-like blood-filled non-endothelialized spaces were observed. Conclusions: Since the breasts become larger due to the physiological changes during pregnancy, any underlying breast lesions may be obscured. Therefore, clinical breast examination in the first visit of pregnancy is important.

scholarly journals Granulocyte-colony stimulating factor-producing malignant phyllodes tumor of the breast: a rare case

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Kimihisa Mizoguchi ◽  
Kazuhisa Kaneshiro ◽  
Makoto Kubo ◽  
Yoshihiko Sadakari ◽  
Yoshizo Kimura ◽  
...  
Keyword(s):  
Rare Case ◽  
Phyllodes Tumor ◽  
Left Breast ◽  
Lymph Node Biopsy ◽  
Granulocyte Colony Stimulating Factor ◽  
Colony Stimulating Factor ◽  
Malignant Phyllodes Tumor ◽  
Csf Levels ◽  
Wbc Count ◽  
Stimulating Factor

Abstract Background Granulocyte-colony stimulating factor (G-CSF)-producing tumors can cause leukocytosis despite an absence of infection. G-CSF-producing tumors have been reported in various organs such as the lung, esophagus, and stomach but rarely in the breast. We report a case of G-CSF-producing malignant phyllodes tumor of the breast. Case presentation An 84-year-old woman visited our hospital complaining of a lump in her left breast without fever and pain. Laboratory tests revealed elevated white blood cell (WBC) count and G-CSF levels. A malignant tumor of the breast was diagnosed by core needle biopsy. We performed a total mastectomy and sentinel lymph node biopsy. The tumor was identified as a G-CSF-producing malignant phyllodes tumor. Within 7 days after surgery, the patient’s WBC count and G-CSF level had decreased to normal levels. She is alive without recurrence 13 months after surgery. Conclusions We encountered a rare case of G-CSF-producing malignant phyllodes tumor of the breast. PET–CT revealed diffuse accumulation of FDG in the bone. Phyllodes tumors need to be differentiated from bone metastasis, lymphoma, and leukemia. We must be careful to not mistake this type of tumor for bone marrow metastasis.

scholarly journals Is It Contralateral Axillary Metastasis or Occult Breast Cancer: A Confusing Case Report

2015 ◽  
Vol 8 (3) ◽  
pp. 498-502 ◽  
Author(s):  
Yong Gi Son ◽  
Woon Won Kim ◽  
Ki Hoon Kim ◽  
Jin Soo Kim
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Growth Factor Receptor ◽  
Immunohistochemical Analysis ◽  
Breast Conserving Surgery ◽  
Left Breast ◽  
Lymph Node Biopsy ◽  
Adjuvant Radiation ◽  
Axillary Lymph ◽  
Axillary Metastasis

We report the case of a 43-year-old woman with primary left breast cancer presenting metastatic lymphadenopathy in the contralateral axilla. This patient represents a diagnostic and therapeutic challenge because primary breast cancer, occult contralateral breast cancer, and extra-mammary primary lesion can all be the source of the contralateral axillary metastasis. Left breast-conserving surgery, left sentinel lymph node biopsy, right breast mass excision, and right axillary lymph node dissection were performed. Immunohistochemical analysis revealed that the left breast cancer specimen was positive for estrogen receptor (ER) and progesterone receptor (PR), but negative for human epidermal growth factor receptor 2 (HER2). In contrast, the right axillary lymphadenopathy specimen was negative for ER and PR, but positive for HER2. Further investigation revealed no evidence of occult primary cancers or extra-mammary tumors. After surgical intervention, the patient was treated with adjuvant chemotherapy, adjuvant radiation therapy, and targeted therapy with trastuzumab. Two years after diagnosis, she is free of disease and presently being treated with tamoxifen.

scholarly journals A Case Report: First Report of a Primary Breast Leiomyosarcoma with Lymph Node Metastasis in Lebanon

2020 ◽  
Vol 1 (1) ◽  
pp. 34-38
Author(s):  
Hussein Hmadeh ◽  
Mohammad Rakka ◽  
Layan Abbas ◽  
Nizar Bitar ◽  
Raed Chehab El Dine ◽  
...  
Keyword(s):  
Case Report ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Radical Mastectomy ◽  
Left Breast ◽  
Breast Mass ◽  
Histologic Subtype ◽  
Node Metastasis ◽  
First Case ◽  
Primary Leiomyosarcoma

Background: Primary leiomyosarcoma (LMS) of the breast is an extremely rare histologic subtype of malignant breast tumors. While breast sarcomas account for 0.0006% of all breast malignancies, primary leiomyosarcoma constitutes only 5-10% of breast sarcomas themselves. To date, the total number of reported cases in the literature is less than 70 cases with the first case reported in 1968. This is, to the best of our knowledge, the first case reported from Lebanon, with only 2 cases previously reported in the Middle East, specifically in Morocco. Case Report: We report the case of a 48-year-old, white, previously healthy female patient, presenting for a breast mass. She first noticed it three months prior to presentation in her left breast and reports that since then, the lump has been growing and her breast has become more painful and erythematous over time. Physical examination revealed an immobile and tender mass of around 12 cm in diameter. A core biopsy was done followed by a left modified radical mastectomy with lymph node dissection. Pathology of the specimen showed a tumor composed of spindle cells arranged in fascicles invading the dermis, with irregular nuclei and prominent nucleoli. Immunohistochemical staining confirmed the diagnosis of high-grade leiomyosarcoma. Conclusion: We presented this case of leiomyosarcoma with lymph node metastasis to contribute to the scarce literature regarding this disease. Due to the rarity of this diagnosis, not enough data exists regarding treatment and prognosis. Physicians need to review the literature for relevant cases to achieve the best outcome for their patients. Keywords: breast mass, leiomyosarcoma, rare, case report, breast sarcomas, lymph node

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