Malignant Phyllodes Tumour in a Pregnant Woman Masquerading Clinically as an Abscess: A case report
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Abstract
Phyllodes tumors (PT) are rare breast tumours comprising of < 1% of all breast tumours that arise from the stromal connective tissue of the breast. These tumors usually affect the adults of fifth and sixth decade and are rarely found in the pediatric or young age group. PT presents as a rapidly growing discrete palpable mass. Histologically, they are classified as benign, borderline, and malignant on the basis of histological features, mitotic index, necrosis, and infiltrative growth pattern. Malignant PT is a rare entity in pregnancy. We present a case of 27-year-old multigravida with one live male child and a term still born who presented to the outpatient department during antenatal visit with a rapidly growing breast lump early in the 25th week of gestation. Malignant PT becomes difficult to diagnose in a pregnant woman as lactation changes and clinical appearance can mask this diagnosis. A multidisciplinary approach is needed in such cases because there is a high recurrence rate and metastases when tumors are large, bulky with involved surgical margins.
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References
Assi H, Salem R, Sukhon F, Abbas J, Boulos F, Saghir NE. Phyllodes tumors of the breast treated in a tertiary health care center: case series and literature review. J Int Med Res 2020;48:300060518803530.
Zhang WX, Kong XY, Zhai J, Fang Y, Song Y, Wang J. Fatal outcome of malignant phyllodestumor of the breast in pregnancy: a case and literature review. Gland Surg 2021;10:371-7.
Calhoun KE, Allison KH, Kim JN, Rahbar H, Anderson BO. Diseases of the breast. In: Harris JR, Lippman ME, Morrow M, Osborne CK, eds. Diseases of the breast. Philadelphia: Lippincott Williams and Wilkins, Philadelphia 2010:781-92.
Hanby AM, walker C, Tavassoli FA, Devilee P. Pathology and genetics: Tumours of the breast and female genital organs. WHO classification of tumours series - volume IV. Lyon, France: IARC Press. Breast Cancer Res 2004;6:133.
Chaney AW, Pollack A, McNeese MD, Zagars GK, Pisters PW, Pollock RE, et al. Primary treatment of cystosarcoma phyllodes of the breast. Cancer 2000;89:1502-11.
Moffat CJ, Pinder SE, Dixon AR, Elston CW, Blamey RW, Ellis IO. Phyllodestumour of the breast: a clinicopathological review of the thirty-two cases. Histopathology 1995;27:205–18.
Tse G, Koo JS, Thike AA. WHO classification of tumours. Breast tumours—IARC 2019;2:164-65.
Simpson SA, Redstone J, Aziz MS, Bernik SF. Large malignant phyllodes tumor with rapid growth during pregnancy: images of a case. Breast J 2007;13: 620-1.
Alipour S, Eskandari A, Johar FM, Furuya S. Phyllodes tumor of the breast during pregnancy and lactation; A systematic review. Arch Iran Med 2020;23:488-97.
Makar GS, Makar M, Ghobrial J, Bush K, Gruner RA, Holdbrook T. Malignant phyllodes tumor in an adolescent female: A rare case report and review of the literature. Case Rep Oncol Med 2020;1989452: 1-7.
Ellis IO, Lee AHS, Pinder SE. Rakha EA. Breast. In: Fletcher Christopher DM, ed. Diagnostic histopathology of tumors. Philadelphia PA: Saunders/Elsevier 2013:1064.
Telli ML, Horst KC, Guardino AE, Dirbas FM, Carlson RW. Phyllodes tumors of the breast: natural history, diagnosis, and treatment. J Natl Compr Cancer Netw 2007;5: 324–30.
Mustață L, Gică N, Botezatu R, Chirculescu R, Gica C, Peltecu G, et al. Malignant phyllodes tumor of the breast and pregnancy: a rare case report and literature review. Medicina 2021; 58: 36.
Shah-Patel LR. Malignant phyllodes breast tumor. Radiol Case Rep 2017;12:645-7.
Limaiem F, Kashyap S. Phyllodes tumor of the breast. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing 2023.
Li GZ, Raut CP, Hunt KK, Feng M, Chugh R. Breast sarcomas, phyllodes tumors, and desmoid tumors: epidemiology, diagnosis, staging, and histology-specific management considerations. Am Soc Clin Oncol Educ Book 2021;41:390-404.
Rungta S, Kleer CG. Metaplastic carcinomas of the breast: diagnostic challenges and new translational insights. Arch Pathol Lab Med 2012;136:896-900.
Zhang Y, Kleer CG. Phyllodes tumor of the breast: histopathologic features, differential diagnosis, and molecular/genetic updates. Arch Pathol Lab Med 2016;140:665-71.