Aggressive Male Breast Cancer-Clinical and Therapeutic Aspects Correlated with the Histopathological Examination: A Case Report and Literature Review.

Breast cancer is often seen as a disease that occurs in women, but it can also appear in men in a very small percentage, below 1%. Men have a minimal amount of breast tissue compared to women, which has the potential to become malignant in a similar way to women, although much less frequently. A patient presented with advanced local invasion due to the low amount of breast tissue, with the tumor quickly invading the adjacent structures. Histopathological and immunohistochemical examinations have an extremely important role in the pathology of breast cancer. Given that male breast cancer is rare and there are not enough surgeons specializing in breast surgery in our country, there is a lack of experience in the management and early diagnosis of this type of cancer, which will be highlighted in this article.

Diagnostic difficulties in giant benign phyllodes tumor.

Phyllodes tumors (PTs) are rare tumors of the breast, which encompass both stromal and epithelial components. The maximum incidence is in the fourth decade of life. Most of these tumors are benign, but about one third can be malignant acting as sarcomas. Due to their rarity and atypical clinical behavior (especially for the giant ones), the management of these tumors is usually difficult. We report a case of a 24-year-old woman who presented in the Department of Oncology for rapid increase in volume of the left breast. She had no personal pathological or family history. Initial clinical exam showed a large irregular mass in the left breast of approximately 30 cm and palpable lymph nodes in the ipsilateral axilla. A core needle biopsy for the tumor was performed with histopathological (HP) result that revealed an aspect suggesting fibroadenoma/PT. Contrast-enhanced computed tomography (CT) scan identified lymph node enlargement in the left axilla and a peripheral nodule in the lung about 5.5/3.4 mm with no specific features. The patient was then transferred to the Department of Surgery, where left mastectomy and axillary lymph node sampling were performed. HP result of the surgical specimens confirmed the presence of both fibroadenoma and PT, with clear margins above 1 cm, but recommended immunohistochemistry (IHC) to clearly specify benign versus borderline type. Five lymph nodes out of six resected presented microscopic reactive changes. We performed a search of literature using the keywords "giant", "benign" and "phyllodes". The results were used to summarize and discuss some of the main features of this type of tumors as well as diagnostic and therapeutic difficulties.