Giant Fungating Borderline Phyllodes Tumor of the Breast

Abstract

Phyllodes Tumors are rare fibroepithelial neoplasms of the breast, accounting for less than 1% of all breast neoplasms. Preoperative diagnosis of Phyllodes Tumors is not easy, and a definitive diagnosis depends on a complete excision of the tumor. We present a case of a Giant Fungating Borderline Phyllodes Tumor of the breast. The main objective is to share our experience with the Phyllodes tumor of the breast from Mankweng Academic Hospital, Limpopo, South Africa. Case Report:  A 50-year-old postmenopausal patient presented to our Breast Oncology clinic with a history of a slow-growing left breast mass for a duration of more than 1 year. It started as a small mass and progressively increased in size. She previously had two core needle biopsies, of which both histological analyses were inconclusive. In the last four months, there were multiple ruptured round masses associated with pain, bleeding, and an offensive discharge. The patient does not have any family history of breast cancer. On examination, the left breast has a fungating mass of 15×15 cm, with areas of necrosis and hemorrhage. There were no associated axillary lymph nodes and no abnormal findings in the right breast. Chest X-ray: normal. A mammogram was not done owing to the fear and risk of bleeding. A mastectomy was performed, and it was a highly vascularized mass. The excised specimen weighed 2.7 kg and was sent for histological assessment, which showed features of fibroepithelial proliferation consistent with Borderline Phyllodes Tumor with areas of stromal atypia, focal increase in cellularity, mitosis 5 per 10 High Power Field (HPF), and clear surgical margins of 0.9 millimeters (mm). The patient was reviewed six weeks after the operation. Conclusion: Owing to the rare nature and misdiagnosis of Phyllodes tumors, it is important to obtain a tissue biopsy for histological assessment of all suspicious breast lesions, regardless of age. Doi: 10.28991/SciMedJ-2023-05-02-04 Full Text: PDF