Malignant phyllodes Tumor of the Breast; Presentation of an Uncommon Case and Review of the Literature

Background: Phyllodes tumours are rare fibroepithelial neoplasm ofconnective tissue of the breast accounting for 0.3-1% of all breast tumours with10% of them being malignant. They resemble fibroadenomas clinically and can bemistakenly ignored.Case presentation: A 38-year-old unmarried Philipino lady presented to theprimary health center with a mass in the right breast for the past year. Over thepreceding 6 months, it had progressively increased in size and pain. Onexamination, a 5 x 3 cm firm and lobulated mass was palpated in the right upperouter quadrant. Ultrasound scan showed a solid 4.25 x 3.3 x 2.4 cm mass withheterogeneous mixed echopattern. She was referred to Surgery department wherean ultrasound-guided core biopsy showed a lesion suspicious for benign phyllodestumor. An excision biopsy revealed three foci of malignant Phyllodes on thebackground of fibroadenoma. A staging CT was performed which showed noevidence of lymph node involvement or distant metastasis. A simple mastectomywas performed and histopathology confirmed the diagnosis of malignantphyllodes tumor. Postoperatively, the patient is on regular follow up in the breastclinic and physiotherapy department. Conclusion: Phyllodes tumor bears specific clinical characteristics and shouldbe considered as a differential diagnosis in any mass lesion of the breast..Diagnosis and management are crucial in phyllodes tumor because of theirmalignant potential recurrence. Clinicians should be competent in distinguishingbetween fibroadenoma and a phyllodes tumor. Lastly, given the rarity of phyllodestumors, there is a need to establish guidelines to incorporate regular follow up forearly detection of distant metastasis.

Malignant phyllodes Tumor of the Breast; Presentation of an Uncommon Case and Review of the Literature Keywords:

Breast cancer , phyllodes tumor , malignancies