A rare case of a large breast phyllodes tumor

Abstract

Introduction: Phyllodes tumor is a rare form of breast cancer, and the malignant form, the rarest presentation. Although the Phyllodes tumors rarely metastasizes, they can grow faster than any other breast tumor. Diagnosis and treatment are crucial, and surgery is the first line of action. Large tumors represent a surgical challenge because the excision with free margins is essential to prevent local recurrence and metastatic spread. In this presentation, we report a rare case of a giant Phyllodes tumor weighing 7.15 kg on a 66-year-old woman and a review of the literature highlighting some issues surrounding the management of phyllodes tumors. Case Report: A 66-year-old women, without known relevant precedents, was admitted to breast pathology consult due a large, ulcerated and infected tumor. An incisional biopsy revealed borderline Phyllodes tumor. No distant metastasis were identified. After infection control, a left mastectomy was performed, with primary closure of the defect by mobilizing the skin flaps. The postoperative period was uneventful. Pathological examination revealed a 30x28x18 cm, 7150 gr malignant Phyllodes tumor with free margins. After one year follow-up there is no evidence of local or distant recurrence. The patient refused plastic reconstructive surgery. Conclusion: Phyllodes tumor is a rare breast tumor, with the malignant phenotype being the rarest of them all. Surgical therapy is the gold standard for the treatment of phyllodes tumors. Phyllodes tumors should be removed with, at least, 1 cm free margins, especially if they’re malignant tumors. The role of adjuvant therapy is still controversial.