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[Pulmonary metastatic malignant phyllodes tumor showing multiple thin walled cavities]
M Yagishita1, Y Nambu, M Ishigaki
1Department of Internal Medicine, Kanazawa Medical University, Ishikawa, Japan.
Summary
Pulmonary metastasis from a benign phyllodes tumor is rare. This case highlights thin-walled cavities as a key radiographic sign of malignant phyllodes tumor lung metastasis.
Area of Science:
- Oncology
- Pulmonary Medicine
- Pathology
Background:
- A 52-year-old woman with a history of benign phyllodes tumor of the breast presented with respiratory symptoms.
- Initial investigations for dry cough and abnormal chest radiograph were inconclusive.
Observation:
- Chest imaging revealed multiple thin-walled pulmonary cavities and nodules.
- Transbronchial biopsy failed to establish a diagnosis.
- Progressive enlargement of pulmonary cavities and nodular cavitary formation were noted.
Findings:
- Open lung biopsy identified poorly differentiated adenocarcinoma cells in the pleura and lung parenchyma.
- Immunohistochemistry confirmed the pulmonary malignant cells were identical to those from the earlier mastectomy.
- The patient received chemotherapy (CDDP and VP-16) with no response and died from respiratory failure.
Implications:
- This case underscores the rare but critical diagnosis of pulmonary metastasis from malignant phyllodes tumor.
- Thin-walled cavitary lesions on chest imaging can be a radiographic manifestation of this condition.
- Malignant phyllodes tumor metastasis requires consideration in the differential diagnosis of unexplained pulmonary cavities.