PMC5010640_01
Initial mammogram shows lobulated mass on right breast with architectural distortion.
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A bilateral mammogram of breast revealed 20 x 20 cm lobulated mass on right breast with architectural distortion and asymmetry (Fig. 1).
(a) Giant phyllodes tumour with prominent dilated subcutaneous vessels.(b) The fungating giant phyllodes tumour. (a, b): The fungating giant phyllodes tumour with prominent dilated subcutaneous vessels.
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At that time, she was emaciated/malnourished and anaemic with a fungating mass (approximately 50 x 50 cm) occupying over the entire right chest wall with enlarged prominent cutaneous blood vessels (Fig. 2a, b).
CT chest showing heterogeneous enhancing mass in right breast with ill-defined deep margin.
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CT scan of the chest revealed a heterogeneous enhancing mass in right breast with ill- defined deep margin at the RUOQ with few enlarged axillary lymph nodes with no suspicious features and there were no obvious chest wall or pulmonary metastasis were noted (Fig. 3). CT abdomen and pelvis showed no liver and bony metastasis.
Chest wall after excision of phyllodes tumor.
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Right wide mastectomy with partial excision of pectoralis major with axillary lymph nodes sampling (Fig. 4, Fig. 5) and immediate latissimus dorsi (LD) flap closure (Fig. 6) was performed.
LD flap to cover the anterior chest wall.
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Right wide mastectomy with partial excision of pectoralis major with axillary lymph nodes sampling (Fig. 4, Fig. 5) and immediate latissimus dorsi (LD) flap closure (Fig. 6) was performed.
Photograph taken on postop follow up.
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The patient had a successful postop recovery (Fig. 7).
(a) Leaf like growth pattern with hypercellular stoma characteristic of benign phyllodes. (b) Stromal cellularity with scanty mitoses and minimal nuclear atypia.
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Histology of the specimen revealed a low grade (benign) phyllodes tumour with scanty mitoses and minimal nuclear atypia (Fig. 8a, b).