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Malignant phyllodes tumor with chondrosarcomatous differentiation: radiological-pathological correlation.

Kathyayini Paidipati Gopalkishna Murthy¹, Ranjani Padmanabhan Chakravarthy²

¹Department of Radiology, American Oncology Institute and Citizens Hospitals, Hyderabad, Telangana, India.

Journal of Clinical Imaging Science

|October 23, 2014

Summary

This case report details a rare malignant phyllodes tumor of the breast with extensive chest wall invasion and intrathoracic spread. Aggressive imaging features highlighted the need to consider this diagnosis alongside sarcomas.

Keywords:

Chondrosarcomatous differentiation chest wall erosion intrathoracic extension malignant phyllodes phyllodes tumor

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Area of Science:

Oncology
Pathology
Radiology

Background:

Malignant phyllodes tumors are rare breast neoplasms.
Aggressive presentations can mimic primary chest wall malignancies.

Purpose of the Study:

To report a unique case of malignant phyllodes tumor with extensive local invasion.
To highlight the importance of considering phyllodes tumors in the differential diagnosis of aggressive chest wall lesions.

Main Methods:

Case presentation of a 63-year-old woman.
Review of imaging findings including chest wall destruction and intrathoracic extension.
Histopathological analysis of the resected tumor specimen.

Main Results:

Imaging revealed a large, dumbbell-shaped cystic mass with peripheral enhancement, suggestive of a malignant chest wall tumor.
Histopathology confirmed a malignant phyllodes tumor with stromal overgrowth and chondrosarcomatous differentiation.
The tumor demonstrated significant rib destruction, chest wall invasion, and intrathoracic extension.

Conclusions:

Malignant phyllodes tumors can present with aggressive radiological features, including chest wall invasion and intrathoracic extension.
This case represents the first description of such extensive local invasion by a phyllodes tumor.
Sarcomas and malignant phyllodes tumors should be considered in the differential diagnosis of lesions with similar aggressive imaging characteristics.