The malignant degeneration of a phyllode tumour in man: A case report

Malignant phyllodes tumours of the breast represent less than 1% of all breast cancers. Few cases of phyllodes tumours have been reported in men.

We present the case of a 60-year-old man who was operated on one year ago for a breast tumour that had undergone a lumpectomy with an anatomopathological study in favour of a grade 2 phylloid tumour. He was admitted to hospital with a palpable mass in his right breast. The lumpectomy enlarged to the right pectoralis major muscle was then performed with clear surgical margins. Microscopic examination revealed high-grade malignant phyllodes. Postoperatively, after 3 months, the patient was given a breast MRI and a PET/CT scan which returned without abnormalities. The patient is followed for eight months and has shown no signs of recurrence.

Malignant phyllodes tumours of the breast show clinical and mammographic signs comparable to those of benign lesions. The diagnosis is confirmed by histology, treatment is based on surgery, which may be a large lumpectomy or mastectomy, and the prognosis depends on several factors, the most important of which is the margin for surgical resection.

The best treatment is a wide local excision with a safety margin of 1 cm, unless it is metastatic. Early diagnosis and surgery improves the prognosis.