Abstract
BackgroundMalignant phyllodes tumors (PTs) of the breast occur infrequently and are difficult to treat with adjuvant therapy. Here, we present a case of a female patient with a huge malignant PT with rapid progression in a short period.Case presentationA 44-year-old woman presented to our hospital with a rapid growth mass in her right breast, measuring 20 cm. She was initially diagnosed as having a borderline phyllodes tumor by core needle biopsy and underwent total mastectomy and artificial dermis was grafted, 20 days later, latissimus dorsi muscle flap and free skin grafting were performed. Two courses of doxorubicin–ifosfamide therapy were administered because of recurrence, but the patient died 4 months after the mastectomy.ConclusionsA standard therapeutic strategy for malignant PTs is needed in urgently to reduce the risk of tumor recurrence.
Highlights
Malignant phyllodes tumors (PTs) of the breast occur infrequently and are difficult to treat with adjuvant therapy
A standard therapeutic strategy for malignant PTs is needed in urgently to reduce the risk of tumor recurrence
As PTs are considered as soft-tissue sarcoma, adjuvant chemotherapy with doxorubicin plus dacarbazine may provide some benefits to patients with large (> 5.0 cm), high-risk tumors [17]
Summary
Phyllodes tumors (PTs) of the breast are extremely rare, globally accounting for 0.3% to 1% of breast tumors [1] Their name is derived from the Greek phyllon (leaf ) because of its lobed histological appearance. It is known as cystosarcoma phyllodes, adenomatous myxoma, and pseudosarcoma adenoma [1,2,3]. A. Because 1 month after the mastectomy the tumor had re-grown in the surrounding skin graft and right pleural effusion had appeared (Fig. 5), as an alternative treatment, we administered two courses of doxorubicin– ifosfamide (AI) therapy (30 mg/m2 doxorubicin on days 1–2 and 2 g/m2 ifosfamide on days 1–5) including Mesna (sodium 2-mercaptoethane sulfonate) and sufficient infusion volumes to prevent ifosfamide-related hemorrhagic cystitis. The patient died 4 months after the mastectomy because of respiratory failure
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