A Case of a Giant Phyllodes Tumor of the Breast with Pulmonary, Atrial, and Paranasal Sinus Metastases Early after Surgery

Abstract

Phyllodes tumors of the breast are rare, accounting for 0.3-0.9% of primary breast tumors, of which up to 16-30% are malignant.

A 47-year-old woman underwent right mastectomy, latissimus dorsi myocutaneous flap, and split-thickness skin graft for a 35-cm tumor in the right breast. The resected specimen weighed 7.9 kg ; the postoperative pathological diagnosis was a borderline phyllodes tumor. Six months postoperatively, contrast-enhanced computed tomography showed a mass shadow in the lung. Thoracoscopic partial resection of the left lung was then performed for establishing a diagnosis and initiating treatment. Upon specimen reevaluation at the time of metastasis, its features were found to be consistent with those of malignant phyllodes tumors, hence the revision of the diagnosis. Subsequently, rapidly growing tumors developed in the right atrium and paranasal sinuses and were clinically evaluated as systemic metastases of the malignant phyllodes tumor. We present a rare case of a phyllodes tumor metastasizing to the nasal cavity.

To conclude, this was reported as a rare case of a giant phyllodes tumor of the breast with pulmonary, atrial, and nasal metastases.