A Rare Case of Recurrent Phyllodes Tumor of Bilateral Breasts with Metastasis to the Retroperitoneum and Duodenum

Andrew M. Nouri, Poya Pourghaderi, Sara E. Chapin, Z. Nemeth, Zubin M. Bamboat
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Abstract

Phyllodes tumors are uncommon fibroepithelial tumors of the breast. These tumors are graded based on the World Health Organization criteria into benign, borderline, and malignant subtypes. While benign phyllodes tumors are by far the most common presentation, borderline and malignant tumors have important clinical implications, as they are more likely to locally recur and metastasize. The most common sites of distant metastasis include the lung, bone, heart, and liver. Rare spread to the small intestines, kidney and pelvis have also been reported. We report a case of a 71-year-old woman with a history of locally recurrent phyllodes tumor of the breasts found to have retroperitoneal and intraperitoneal metastases. The retroperitoneal mass was just below the left kidney, extending into the pelvis, and overlying the psoas and iliacus muscle. The second mass involved the second portion of the duodenum, the proximal transverse colon, and the overlying mesentery. This is a rare case of delayed metastatic spread of phyllodes tumor to two sites, seventeen years after first presentation.
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双侧乳腺叶状瘤复发并腹膜后及十二指肠转移一例
叶状瘤是一种罕见的乳腺纤维上皮性肿瘤。这些肿瘤根据世界卫生组织的标准分为良性、交界性和恶性亚型。虽然良性叶状瘤是迄今为止最常见的表现,但交界性和恶性肿瘤具有重要的临床意义,因为它们更容易局部复发和转移。最常见的远处转移部位包括肺、骨、心和肝。罕见的扩散到小肠、肾脏和骨盆也有报道。我们报告一例71岁的妇女与局部复发的乳腺叶状瘤的历史发现有腹膜后和腹膜内转移。腹膜后肿块位于左肾下方,延伸至骨盆,并覆盖腰肌和髂肌。第二个肿块累及十二指肠第二部分、近侧结肠和上覆肠系膜。这是一个罕见的延迟转移扩散到两个部位的叶状肿瘤,17年后首次提出。
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