Malignant phyllodes tumor of the breast with bilateral ductal carcinoma in situ and postoperative distant metastasis: a case report

Abstract

Background: Phyllodes tumors (PTs) are breast neoplasms with varying degrees of malignancy, posing challenges in diagnosis and management. This case report focuses on a rare case of malignant phyllodes tumor of the breast (MPTB) in a 35-year-old woman. Case Description: This case report presents a complex scenario of a patient with extensive breast abnormalities, including a malignant PT in the left breast, ductal carcinoma in situ in both breasts, with axillary lymph node involvement. Radiological examinations revealed multiple masses with varying characteristics, leading to a challenging diagnosis. Considering a huge malignant breast tumor, surgery was suggested immediately without biopsy. Surgical intervention, including modified radical mastectomy, was performed, and pathological findings diagnosed of malignant PT with intraductal carcinoma. The patient experienced disease progression shortly after surgery, with metastases detected in the left axillary lymph node and both lungs at the third month after discharge. Despite further treatment is suggested, the patient refused the treatment options. The patient’s condition rapidly deteriorated, leading to her unfortunate demise four months after surgery. Conclusions: This case accentuates the complex nature of MPTB, highlighting the urgent need for seeking medical attention promptly, sufficient preoperative assessment, improved diagnostic techniques, interdisciplinary collaboration, and advanced treatment.