Phyllodes tumor masquerading as a fungating breast mass

Area of Science:

• Oncology
• Pathology
• Surgical Oncology

Background:

• Phyllodes tumors are rare breast neoplasms, accounting for less than 1% of all breast tumors.
• Malignant phyllodes tumors represent a subset of these rare tumors with aggressive potential.
• Unusual presentations, such as fungating or 'ruptured' breast masses, are exceptionally uncommon.

Observation:

• A 60-year-old female presented with a large, exophytic left breast mass.
• The initial biopsy was non-diagnostic, delaying definitive diagnosis.
• The patient underwent a left total mastectomy due to the lesion's size and uncertain nature.

Findings:

• Final histopathological examination confirmed a malignant phyllodes tumor.
• The tumor's advanced presentation complicated initial diagnostic efforts.
• Malignant phyllodes tumors require careful pathological assessment for accurate grading and treatment planning.

Implications:

• This case underscores the diagnostic challenges associated with rare breast malignancies.
• Prompt and accurate diagnosis is crucial for effective management of malignant phyllodes tumors.
• Surgical excision remains a primary treatment modality, with adjuvant therapies considered based on tumor characteristics.