Invasive ductal carcinoma within borderline phyllodes tumor with lymph node metastases: A case report and review of the literature

Abstract

Phyllodes tumor (PT) is a rare type of biphasic fibroepithelial neoplasm that may coexist with a breast tumor in rare cases. In the current study, a 52-year-old female presented with a left breast lump. Mammography and sonographic examination results suggested a diagnosis of malignant tumor. Histological analysis revealed a borderline PT with invasive ductal carcinoma (IDC) within the tumor. Due to the presence of a single micrometastasis in three of the sentinel lymph nodes, the patient underwent modified radical mastectomy. The excised tumor contained triple negative breast cancer; therefore, postoperative treatment included six cycles of chemotherapy and 25 cycles of radiotherapy. The patient exhibited no recurrence and no metastatic disease at the 23-month follow-up examination. Thus, the present study discussed the case of a female patient that presented with IDC within borderline PT and reviewed the literature on this rare type of neoplasm. Various types of breast carcinoma have been identified to coexist with PT in different masses; however, no standard therapeutic regimen has been established for the coexistence of PT and breast cancer in the same mass. The present study indicates that determination of an appropriate treatment strategy predominantly depends on the characteristics of the individual breast tumor.

Keywords: breast cancer; coexist; diagnosis; phyllodes tumor; treatment.

Figure 1.

Mammography image revealing a high-density mass with an irregular margin and a diameter of 2.5 cm in the outer upper quadrant of the left breast. The mass was determined as grade 4, according to the Breast Imaging Reporting and Data System classification.

Figure 2.

Sonographic examination revealing an irregular, partially ill-defined, hypoechoic mass with a diameter of 2.1 cm. The mass was diagnosed as grade 4B, according to the Breast Imaging Reporting and Data System classification.

Figure 3.

Invasive ductal carcinoma (black arrow) detected within a region of spindle cells (blue arrow) in the phyllodes tumor (hematoxylin and eosin stain; magnification, x100).

Figure 4.

Immunohistochemical staining of the invasive ductal carcinoma, revealing positive pan-cytokeratin expression (stain, hematoxylin and eosin; magnification, x100).