Recurrent Benign Phyllodes Presenting as High Grade Malignancy: A Case Report

Abstract

Johannes Muller initially described Phyllodes Tumours (PT) to be “cystosarcoma phyllodes” in 1838. The connotation for the term “phyllodes” is leaf like, which on pathologic examination gives appearance of typical papillary projections. The PT are fibroepithelial in nature and account for an unbefitting 1% of overall primary neoplasms of the breast. They are known for its rapid growth and seen in women of 35-55 years of age, with a mean age of presentation as 45 years. Regardless of the histology recurrence is very common, in both malignant and benign PT. The stromal pattern of expression of CD10 marker strongly correlates with the grade of PT thus helps in the differentiating between malignant and benign variants of PT. Authors hereby, discuss a case of 48-year-old female patient with recurrent PT of breast who underwent surgical excision of benign phyllodes tumour twice and presented with a briskly growing recurrent lump in the left breast for the third time, diagnosed as malignant PT. Very finite data is available on the outcome of surgical management and the advantage of adjuvant Radiation Therapy (RT) in PT. The PT carry high risk of recurrence as well as become aggressive when malignant in nature. Thus, wide local excision of the tumour with negative margins should be followed by adjuvant chemotherapy and radiotherapy to decrease the recurrence rate.