PMC4756194_01
Mammogram of the left breast. A lobulated mass with a smooth surface could be seen. Mammogram of the right breast was not performed due to the presence of a huge mass and skin ulceration.
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Mammogram of the left side revealed a lobulated mass with a smooth surface in the upper outer quadrant of the left breast (Fig. 1), but no mammogram of the right side was performed due to the presence of a huge mass with skin ulceration.
Ultrasonography of the left breast at first presentation (A) and after 3 months of anti-HER2 chemotherapy (B). A well-defined, low-echoic mass with a homogeneous intratumoral echoic pattern could be seen at first presentation (A). After 3 months of anti-HER2 chemotherapy, the mass suddenly enlarged and contained fluid, potentially suggesting intratumoral hemorrhage (B).
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Ultrasonography of the left breast revealed a well-defined, low-echoic mass with a homogeneous intratumoral echoic pattern, suggesting a benign tumor (Fig. 2A). After 3 months, the BC had shrunk markedly and finally disappeared on physical examination and CT, while the mass in the left breast enlarged suddenly (Fig. 2, Fig. 4).
Histology of the core needle biopsy from the left breast tumor. Fibroadenoma rather than phyllodes tumor was diagnosed due to the absence of a leaf-like pattern, stromal overgrowth or mitosis.
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HER2-positive invasive carcinoma in the right breast and fibroadenoma (FA) rather than PT in the left were diagnosed by core needle biopsy (Fig. 3).
Macroscopic findings of the resected left breast tumor. The mass was 100 x 90 x 70 mm with massive hemorrhagic necrosis.
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The mass was 100 x 90 x 70 mm with massive hemorrhagic necrosis (Fig. 5).
Histology of the left breast tumor. A, Panoramic view shows benign, borderline and malignant parts of PT and their transition (arrowhead). B, Magnified view of the benign part of the PT. C, Magnified view of the malignant part of the PT. Dense atypical spindled mesenchymal cells with numerous mitoses (50 mitoses/10 high-power fields) can be seen.
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Histologically, the mass was composed of dense atypical spindled mesenchymal cells with numerous mitoses (50 mitoses/10 high-power fields, Fig. 6). Benign PT was also observed next to the malignant component (Fig. 6), and malignant PT was diagnosed.