Recurrent Malignant Phyllodes Tumor of the Breast: A Case Report

Malignant phyllodes tumors of the breast are rare fibroepithelial neoplasms with aggressive behavior and high recurrence rates. They pose significant diagnostic and therapeutic challenges due to their overlap with other malignancies, necessitating accurate diagnosis and a tailored treatment approach to improve patient outcomes. A 29-year-old Asian female initially underwent a lumpectomy for a right breast mass diagnosed as a phyllodes tumor on histopathology. Six months later, she developed a recurrent mass with pain, bleeding, and nipple-areolar distortion, leading to a modified radical mastectomy. Histopathology unexpectedly revealed metaplastic carcinoma, giant cell variant. No adjuvant therapy was administered. Two years post-mastectomy, she presented with a recurrent axillary mass associated with necrosis and purulent discharge. Imaging revealed a large necrotic soft tissue mass confined to the chest wall and axilla with subcentimeter lung nodules. No muscle invasion or intrathoracic extension was noted. Wide local excision of the axillary mass confirmed recurrent malignant phyllodes tumor. This case highlights the aggressive and recurrent nature of malignant phyllodes tumors, emphasizing their diagnostic overlap with other malignancies such as metaplastic carcinoma. Despite multiple surgical interventions, the high recurrence risk underscores the importance of precise diagnostic techniques and individualized treatment strategies.