Multifocal intra-parenchymal and sub-pectoral malignant phyllodes tumor in young female, rare and unusual presentation: A case report

• Published in: International journal of surgery case reports 2020-01, Vol.71, p.280-284
• Main Authors: Athamnah, Mohammad Naser, Abuelaish, Omar M., Rabai, Nimah A.
• Format: Article
• Language: English
• Subjects: Immediate reconstruction; Malignant phyllodes tumor; Multifocal phyllodes; Sub-pectoral phyllodes
• ISSN: 2210-2612; 2210-2612
• DOI: 10.1016/j.ijscr.2020.05.014

•To the best of our knowledge, the current report is the first to mention Sub-pectoral breast primary phyllodes tumor.•Phyllodes tumors usually present in 35–55 years old female patients but should be suspected in any fast-growing breast mass, even in young age groups.•In this case the patient preferred adjuvant radiotherapy to the nipple-areola complex and surrounding skin instead of surgical excision although results are oncologically inferior.•Early diagnosis and initiation of appropriate treatment of Phyllodes tumors may lead to prevent metastasis and improve outcomes. Phyllodes tumors are rare fibroepithelial breast tumors, accounting for less than 1% of all breast tumors. Most Phyllodes tumors are benign. However, about 10% are malignant. The Mean age of presentation for the Malignant Phyllodes tumors is 40 years. This case report describes an unusual presentation of Phyllodes tumor in a young female with an unusual site and presentation of the tumor. A 23-year-old female presented with multiple left breast rapidly growing masses. Imaging showed two intra-parenchymal left breast masses and one mass lying posterior to the left pectoralis major muscle, anterior to the chest wall. Diagnosed as phyllodes tumor. Nipple areola sparing mastectomy was performed with excision of the tumor and immediate reconstruction using a silicone implant, followed by radiotherapy. Phyllodes tumor usually presents in patients between 35–55 years old as a single breast mass. Yet, in rare cases, multifocal disease can happen, and disease can present in younger ages. The sub-pectoral presentation of phyllodes tumor is not mentioned in the literature before this case.