Ann Surg Treat Res.  2017 Feb;92(2):110-112. 10.4174/astr.2017.92.2.110.

Fulminant course in a case of malignant phyllodes tumor

Affiliations
  • 1Department of Breast Endocrine Surgery, Korea University College of Medicine, Seoul, Korea. gsson@korea.ac.kr
  • 2Department of Plastic and Reconstructive Surgery, Korea University College of Medicine, Seoul, Korea.

Abstract

We present the case of a 31-year-old woman with an inflammatory and ulcerative malignant phyllodes tumor in her right breast. A right modified radical mastectomy and transverse rectus abdominis myocutaneous (TRAM) flap were performed. A month after the initial operation, several masses recurred at the superior margin and deep margin of the TRAM flap. Wide excision was performed, but masses recurred at the inferior margin and in both lung fields 2 weeks after the second operation. Six weeks after the second operation, the patient died due to progression of dyspnea and respiratory failure.

Keyword

Phyllodes tumor; Phyllodes tumor; Breast neoplasms

MeSH Terms

Adult
Breast
Breast Neoplasms
Dyspnea
Female
Humans
Lung
Mastectomy, Modified Radical
Phyllodes Tumor*
Rectus Abdominis
Respiratory Insufficiency
Ulcer

Figure

  • Fig. 1 (A) An inflammatory and ulcerative mass in the right breast. (B) Post modified radical mastectomy image showing en bloc removal of the tumor including the invaded pectoralis muscle. (C) Mass-like protruding lesions that appeared at the superior margin of the transverse rectus abdominis myocutaneous flap a month after the initial operation.

  • Fig. 2 (A, B) Breast MRI showing recurrent tumor (84 mm × 48 mm) at the deep margin of the transverse rectus abdominis myocutaneous flap invading the pectoralis minor and intercostal muscles, a month after the initial operation. (C) A chest CT scan for both lung fields showing new round opacities and suggesting metastases (arrows).


Reference

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