Jamjoum Ghader, Alrefaei Mariya, Alhamed Wasan, Alsefri Joud, Abuzinadah Ahmed
Gastrointestinal Oncology Unit, King Abdulaziz University Hospital, Jeddah 22252, Saudi Arabia.
King Abdulaziz University Hospital, Jeddah 22252, Saudi Arabia.
J Surg Case Rep. 2024 Jul 25;2024(7):rjae465. doi: 10.1093/jscr/rjae465. eCollection 2024 Jul.
Phyllodes tumors (PTs) and Metaplastic Malignant Spindle Cell Carcinoma (MMSCC) are rare and challenging breast malignancies. MMSCC is even rarer and highly aggressive. Surgical excision is the mainstay of treatment for both, but MMSCC generally carries a poorer prognosis. A 46-year-old woman with a history of breast augmentation 4 years ago presented with a rapidly progressing right breast mass. Imaging and core biopsy suggested a malignant PT. A right mastectomy with latissimus dorsi flap reconstruction was done. Initially diagnosed as a malignant PT, the post-operative pathology revealed a co-existence of malignant PT and MMSCC, an extremely rare finding. This case reports the unique challenge of a patient harboring both malignant PT and MMSCC within the same breast tissue. This exceedingly rare co-existence emphasizes the diagnostic complexities associated with uncommon breast malignancies. Our case highlights the challenges of diagnosing and managing uncommon and aggressive breast malignancies.
叶状肿瘤（PTs）和化生性恶性梭形细胞癌（MMSCC）是罕见且具有挑战性的乳腺恶性肿瘤。MMSCC更为罕见且侵袭性强。手术切除是二者的主要治疗方法，但MMSCC的预后通常较差。一名46岁女性，4年前有隆胸史，现出现右乳迅速增大的肿块。影像学检查和粗针活检提示为恶性PT。遂行右乳乳房切除术并背阔肌肌皮瓣重建术。最初诊断为恶性PT，术后病理显示恶性PT与MMSCC并存，这一发现极为罕见。本病例报告了同一乳腺组织中同时存在恶性PT和MMSCC患者所面临的独特挑战。这种极其罕见的共存情况凸显了与罕见乳腺恶性肿瘤相关的诊断复杂性。我们的病例突出了诊断和管理罕见且侵袭性乳腺恶性肿瘤的挑战。
