LOW-GRADE MALIGNANT PHILOID TUMOR ASSOCIATED WITH DUCTAL CARCINOMA IN SITU

A CLINICAL CASE REPORT

Abstract

Phyllodes tumors are rare in the breast, ranging from benign to malignant, rarely associated with carcinomas, especially ductal carcinoma in situ. OBJECTIVE: To describe a clinical case of low-grade malignant phyllodes tumor associated with ductal carcinoma in situ GN2. CASE REPORT: Patient E.R.A., 53 years old, presented with a rapidly growing nodule in the left breast in the upper lateral quadrant. Physical examination revealed a well-defined, hardened, and painless nodule. Mammography showed a dense, well-defined, 20 cm nodular lesion in the same location. Following a Fine Needle Aspiration Biopsy (FNAB) with negative cytology and clinically negative axillary nodes, the patient underwent a quadrantectomy to remove the tumor with clear margins. Pathological evaluation confirmed a low-grade malignant phyllodes tumor associated with ductal carcinoma in situ, displaying moderate cellular atypia and high expansibility. The diagnosis was confirmed through immunohistochemical analysis, showing positivity for specific markers. DISCUSSION: Phyllodes tumors (PT) are more common in the 4th to 5th decades, especially among Asian and Latina women. They are typically painless, large, firm, and rarely associated with carcinomas. Considerable growth (up to 41 cm) is common, and axillary involvement is rare. Diagnosis is challenging due to unclear imaging findings. Surgical resection with clear margins is the preferred treatment. CONCLUSION: Epidemiological studies are essential for standardizing phyllodes tumor management, and due to the lack of data, complete resection with clear margins is the best approach.