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. 2013;4(8):687-9.
doi: 10.1016/j.ijscr.2013.04.035. Epub 2013 May 14.

Adrenal metastasis of a phyllodes tumor of the breast: Case report and review of the literature

Yves Collin  1 , François Chagnon, Charles J Mongeau, Gonzalo L Gonzalez-Amaya, Lucas Sideris
Affiliations

Adrenal metastasis of a phyllodes tumor of the breast: Case report and review of the literature

Yves Collin et al. Int J Surg Case Rep. 2013.

Abstract

Introduction: A phyllodes tumor is a neoplasm of mixed mesenchymal and epithelial origin affecting the breast. It may pursue a benign or malignant evolution with distant metastases in the latter case. Sites most commonly affected by metastases are the lungs and bones. Simple mastectomy is the mainstay of treatment. This article presents the first described case of metastasis to the adrenal gland after sarcomatous transformation of a phyllodes tumor. A review of the literature is presented afterwards.

Presentation of case: A 57-year old female patient presented with a voluminous breast mass which was completely resected. Unfortunately she presented with malignant recurrence in the breast which was also resected. A later recurrence within the lung presented and was completely resected but showed aspects of sarcomatous changes. Finally a recurrence was pathologically documented within the adrenal gland. Unfortunately, disease later progressed and the patient refused further treatment at that point.

Discussion: While malignant transformation of breast phyllodes tumors and metastasis is relatively common, the prognosis for initially benign lesion that are completely excised is usually good. This case represents the first documented metastasis to the adrenal gland of a breast phyllodes tumor.

Conclusion: We presented the first case of adrenal metastasis of a phyllodes tumor after sarcomatous degeneration. This is an unusual presentation of a relatively uncommon but well-recognized disease of variable malignant potential.

Keywords: Breast surgery; Breast tumor; CT; Computerized tomodensitometry; Phyllodes tumor.

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Figures

Fig. 1
Fig. 1
High power field of the modified radical mastectomy. Histology shows hypercellularity, pleomorphism, and cellular condensation around the epithelial structures with numerous mitoses. A diagnosis of malignant phyllodes tumor was established.
Fig. 2
Fig. 2
Abdominal CT scan showing heterogeneous left adrenal mass.
Fig. 3
Fig. 3
Histology of the adrenal tumor shows hypercellular mesenchymal proliferation. Comparison with the lung tumor histology suggested another metastasis of the phyllodes tumor.
See this image and copyright information in PMC

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