Malignant phyllodes tumor in a young female patient: a case report

Abstract

Phyllodes tumors of the breast are rare fibroepithelial neoplasms, accounting for less than 1% of breast neoplasms. The malignant subtype, accounting for 10% to 15% of cases, exhibits aggressive behavior, with a high risk of local recurrence and metastasis, primarily to the lungs and bones. This case report describes the clinical course and therapeutic challenges of a young female patient with a malignant phyllodes tumor in the left breast. The patient was a 23-year-old woman who presented with a rapidly growing tumor over less than six months, with extensive ulceration and destruction of the areola-nipple complex. Histopathological examination revealed a moderately differentiated spindle cell neoplasm with high stromal cellularity and a high mitotic index. The patient initially underwent isolated tumor resection, but experienced early recurrence, requiring a mastectomy with reconstruction using a latissimus dorsi flap. Following a new local recurrence, she underwent surgical intervention and adjuvant radiotherapy. With disease progression and the emergence of new lesions, she was referred for palliative treatment with chemotherapy. Clinical data were obtained from medical records, including the history, physical examination, imaging reports, operative descriptions, and histopathological analyses. The patient consented to the use of the information for scientific purposes by signing the informed consent form. The management of malignant phyllodes tumor of the breast represents a clinical challenge due to its low incidence and unpredictable biological behavior. Diagnostic and therapeutic approaches must be individualized and conducted by a multidisciplinary team, aiming to optimize oncological outcomes and provide the best possible care, even in the face of complex clinical situations.