Phyllodes tumor arising in the ectopic breast tissue of axilla- A rare pathology

Abstract

Benign and malignant pathology can develop in ectopic axillary breast tissue (accessory breast), such as fibroadenoma, phyllodes tumor and breast cancer. I present a rare case of 21-years old married female with bilateral breast lumps and a swelling in right axilla. On clinical examination, the impression of bilateral fibro- adenomas and right sided accessory breast with a round mobile 6x5cm swelling in it, which appears like a giant fibroadenoma. Ultrasonography supported the clinical diagnosis. Case was dis- cussed with the patient and family and excision of bilateral fi- broadenoma along with excision of right sided accessory lump was planned. Surgery was carried out under general anaesthesia. Bilateral fibroadenomas were excised by circumareolar incisions and accessory breast was excised through an elliptical incision. Histopathology was sent which later revealed that the mobile mass in right accessory breast was composed of epithelial com- ponent forming ducts and in areas forming leaf like configura- tion. Stroma showing mild to moderate increase in cellularity. Focal areas showing fibroblastic proliferation and foreign body type giant cells. The overlying skin show unremarkable epidermis and dermis. The above mentioned findings were suggestive of a benign phyllodes tumor in right accessory breast. Phyllodes tumor in ectopic breast tissue is an extremely rare oc- currence. Only nine cases have been reported, including tumors of vulva, inguinal region and axilla. This is the third case in the axillary region.