Phyllodes tumour of the breast in 46-year-old
This article describes the case of a 46-year-old female patient with a mass in the right axilla. Her medical history did not reveal any significant findings or a family history of cancer. Doctors diagnosed her with a rare case of phyllodes tumour arising from the ectopic axillary breast tissue.
Palpation, mammography and ultrasound showed no abnormal findings in the bilateral breasts. However, a hard an elastic mass measuring 20 mm was palpable in the right axilla. For further evaluation an ultrasound was performed which showed a well-circumscribed and hypoechoic mass in the right axilla measuring 25 mm. The findings were suggestive of the diagnosis of axillary lymphadenopathy. Similarly, a contrast enhanced CT of the whole body showed a well-defined mass near the medial upper arm on the right axilla. Doctors found no evidence of preliminary malignancy in the breasts or other organs.
Doctors further advised a US-guided core needle biopsy and diagnosed her with a fibroepithelial tumour.
The findings were suggestive of the diagnosis of a firbroadenoma or phyllodes tumour. A phyllodes tumour is a rare tumour of the breast which grows in the connective tissue called stroma. The tumours also grow in the tissues and ligaments that surround the lymph vessels in the breast, blood vessels and ducts. The cells of the tumour have a lef-like appearance. Less than 1% of breast tumours are phyllodes and 90% of the tumours are benign.
Treatment included a tumourectomy as preference of the patient. Histopathological analysis of the tumour confirmed that it was a benign phyllodes tumour. The analysis showed stromal growth and a leaf-like architecture. In addition, the presence of ectopic breast tissue (EBT) around the tumour suggested that the tumour arose in the axillary EBT. This is prevalent in 2% to 6% of the women. Investigations showed EBT extending from the axilla to the inguinal area. Till date only a few cases of phyllodes have been reported. The study states, “To the best of our knowledge, this is the first report of a CT image of a phyllodes tumour arising in the axillary EBT”.
References
Phyllodes tumour arising in the ectopic axillary breast tissue, mimicking axillary lymphadenopathy https://casereports.bmj.com/content/14/5/e243341
