Malignant phyllodes tumor of the breast metastasizing to the peritoneal cavity

ABSTRACT

A fifty-three year old Bahraini female presented with painless rapidly growing mass in the right breast of 3 months duration; no nipple discharge was found. Family history was positive for breast carcinoma in situ in her sister. Lumpectomy was performed. Histopathology proved to be phyllodes tumor; therefore, mastectomy was performed to avoid local recurrence. The patient received local radiation to the mastectomy scar. Four months after the initial surgery, she developed a nodule in the mastectomy scar, left breast lump in the upper outer quadrant and intra-abdominal mass. A fine needle aspiration of the mass in the left breast showed spindle cells with focal atypia and a necrotic background. True-cut biopsy of the intra-abdominal mass showed the metastatic stromal component of the malignant phyllodes tumor with malignant spindle cells. The patient condition worsened, developed bilateral pleural effusions. Adriamycin chemotherapy was planned, but the disease was aggressive enough to end her life within weeks