Giant Benign Mammary Phyllodes Tumor: Report of a Case and Review of the Literature

Abstract

Phyllodes tumor of the breast is an infrequently encountered fibroepithelial neoplasm, which accounts for 0.3–1% of all tumors. Few case reports have described the occurrence of giant phyllodes tumor. To our knowledge, about 20% of phyllodes tumors would be considered giant benign. Complete surgical excision is the standard of care for giant benign phyllodes tumors; axillary lymph node metastasis is rare, and dissection should be limited to patients with pathologic evidence of tumor in the lymph nodes. We report the case of a 40-year-old Mexican woman with giant mammary tumor who underwent a right total mastectomy. The pathology results showed a benign phyllodes tumor 4,857 g in weight and 40.2 × 36.3 × 15 cm in size. We do not suggest adjuvant radiation therapy for patients with benign phyllodes tumors that are widely excised. A review of the pertinent literature was performed.

The Enigma of Giant Phyllodes Tumour

“…Histologically, it can be benign, borderline, or malignant. Phyllodes tumours should be suspected when a patient presents with a large (more than 3 cm), rapidly growing breast swelling that is palpable clinically [ 1 ]. The clinical appearance of this patient matches the suspicion of a phyllodes tumour as described.…”

“…This tumour is an uncommon biphasic fibroepithelial neoplasm of the breast that can be classified into benign, borderline, and malignant. Phyllodes tumour consists of 0.3% to 1% of all breast tumours [ 1 ]. Benign phyllodes tumours constitute 60% to 75%, borderline 15% to 26%, whereas malignant account for 8% to 20% of cases [ 2 ].…”

“… The tumour size can be various and frequently large, with a median size from 4 cm to 5 cm. Giant phyllodes tumour is defined when the size is more than 10 cm [ 1 ]. Multiple terms are used to describe these tumours, such as cystosarcoma phyllodes, cellular fibroadenoma, and juvenile fibroadenoma [ 4 ].…”

“…Multiple terms are used to describe these tumours, such as cystosarcoma phyllodes, cellular fibroadenoma, and juvenile fibroadenoma [ 4 ]. Originally, the term cystosarcoma phyllodes were first introduced by Johannes Müller in 1838 [ 1 , 4 ]. It is originated from the Greek word sarcoma, which means flesh appearance, and phyllon, which means leaflike [ 1 , 4 ].…”

“…Originally, the term cystosarcoma phyllodes were first introduced by Johannes Müller in 1838 [ 1 , 4 ]. It is originated from the Greek word sarcoma, which means flesh appearance, and phyllon, which means leaflike [ 1 , 4 ].…”