Aggressive Giant Fibroepithelial Lesion with Unusual Vascular Stroma—A Case Report

Abstract

The stroma of fibroadenoma and phyllodes tumor usually consists of fibroblastic proliferation. Rarely the stroma contains bundles of smooth muscle. Pseudoangiomatous hyperplasia of the mammary stroma has been described in fibroadenomas. However, true benign vascular stroma has not been reported. We report a case of a 34-year-old Chinese woman who presented with a large mass occupying the entire left breast. Left mastectomy was performed and showed a large, well-circumscribed, lobulated, rubbery-firm tumor measuring 13 ؋ 10 ؋ 6 cm. A 34-year-old Chinese woman presented with a large mass occupying the entire left breast. Left mastectomy was performed that showed a remarkable fibroepithelial lesion with stroma showing extensive vascular proliferation. The patient developed a local recurrence a year later, and the resection was diagnosed as malignant phyllodes tumor with ductal carcinoma in situ. The patient had had right mastectomy 5 years ago in China before coming to Canada. No information on the pathology could be obtained.

Multifocal Tumorous Pseudoangiomatous Stromal Hyperplasia Presenting as Asymmetric Bilateral Breast Enlargement

“…These giant cells are CD34 positive, Factor VIII negative, present abundant cy- toplasm and are moderately pleomorphic [26]. Such cells have also been described in phyllodes tumors [27]. Distinguishing PASH from a phyllodes tumor may at times be challenging because both lesions may be infiltrative and may form slit-like stromal spaces.…”

Mammary Pseudoangiomatous Stromal Hyperplasia Composed of Predominantly Giant Cells: An Unusual Variant

“…(3) had reported rare giant cells in two cases which had gynecomastia and Von Reclinghausen disease. Multinucleated stromal giant cells have also been noted in fibroadenomas and phylloides tumor (7). Marucci et al.…”