Challenging differential diagnosis, Rare disease
Nancy Panko, Anwar A. Jebran, Ameer Gomberawalla, Mark Connolly
Department of Surgery , Presence Saint Joseph Hospital, Chicago, IL, USA
Am J Case Rep 2017; 18:813-816
Phyllodes tumor (PT) is a rare neoplasm of the breast. Concomitant PT with invasive ductal carcinoma (IDC) is an even rarer occurrence. When ductal carcinoma in situ (DCIS) or IDC are detected within the specimen, the management changes from wide local excision to further staging work-up, including sentinel node biopsy and radiation.
CASE REPORT: We report the case of a 70-year-old presented with right breast mass whose pathology showed benign PT with concomitant IDC and DCIS. The patient elected for a wide excision of the mass with sentinel lymph node biopsy, which did not show any involvement. The patient was started on appropriate therapy. She is currently doing well.
CONCLUSIONS: This case highlights the importance of wide local excision for PT as well as prudent histologic examination to rule out other malignant components, as the presence of IDC distinctly changes management.
Keywords: Carcinoma, Ductal, Breast, Carcinoma, Intraductal, Noninfiltrating, Phyllodes Tumor