Khanal Suman, Singh Yogendra P, Bhandari Anuja, Sharma Rashmi
Breast and Thyroid Surgery Unit, Department of GI and General Surgery, Tribhuvan University Teaching Hospital, Nepal.
Department of Pathology, Tribhuvan University Teaching Hospital, Nepal.
Ann Med Surg (Lond). 2018 Nov 2;36:113-117. doi: 10.1016/j.amsu.2018.10.030. eCollection 2018 Dec.
Phyllodes tumors are spectrum of tumors ranging from benign to malignant. Malignant spectrum pose a management challenge for clinicians due to high risks of recurrence and metastasis. Malignant phyllodes tumor with brain, lung and adrenal metastases at the same time is rare.
A 37 years-old unmarried female presented with an ulcerated huge lump in left breast with severe bleeding. Trucut biopsy showed necrosis with spindle cell proliferation with atypia for which she underwent modified radical mastectomy with final diagnosis of malignant phyllodes tumor. Three months after surgery, patient presented with headache, which on further evaluation showed masses in lung, right adrenal and brain.
We presented a rare case of malignant phyllodes tumor with clinical, imaging and histological findings with metastases to multiple sites early in course and poor outcome of the patient despite margin negative resection.
叶状肿瘤是一系列从良性到恶性的肿瘤。恶性叶状肿瘤因其高复发和转移风险，给临床医生带来了治疗挑战。同时发生脑、肺和肾上腺转移的恶性叶状肿瘤很罕见。
一名37岁未婚女性，左乳出现一个溃疡巨大肿块并伴有严重出血。粗针活检显示坏死伴梭形细胞增生及异型性，为此她接受了改良根治性乳房切除术，最终诊断为恶性叶状肿瘤。术后三个月，患者出现头痛，进一步检查发现肺部、右肾上腺和脑部有肿块。
我们报告了一例罕见的恶性叶状肿瘤病例，具有临床、影像学和组织学表现，病程早期即出现多部位转移，尽管切缘阴性切除，但患者预后不良。
