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Case of the Month

November 2014

Patient Data: Female patient 58 years old

Clinical Info: Has a slow growing breast mass that is there since 2003 Patient was examined in 2003 but the lesion looked benign and was not biopsied. No images from 2003 are available She returned in 2013

Oval mass that is for a part well defined and for a part not well defined

Detail image of the well defined part of the lesion

Transverse image of the well defined part

Detail of the not so well defined part

The lesion is several cm's large


Mammography The lesion was biopsied and to our surprise proved to be a malignant phyllodes tumor. Phyllodes tumors tend to grow rapidly and this mass was rather slow growing

This is an image of another women 47 years old with a palpable breast lesion this image was taken in 2008

Transverse image from the mass in 2008 Biopsy showed a fibroadenona

In march 2012 the lesion had grown rather fast

Another image of the mass

The mass is vascularized

An elastogram showed a soft mass. Although the lesion has benign characteristics a repeat 14 G biopsy was performed and we asked the pathologist if the lesion could be a phyllodes tumor

Again the result was fibroadenoma and half a year later the lesion had grown again

The lesion is still vascularized

At the end of 2013 the lesion was so big that we had to use the extended field of view to get the mass in one image. The lesion was again biopsied for the third time and proved to be a phyllodes tumor The patholgist again looked at the older specimen and concluded that these too proved to be phyllodes tumors

Mammography in 2008

Mammography in 2012 In 2013 no new mammography was performed

Although the lesion of the first patient was according to the patient there for 10 years the lesion proved to be a malignant phyllodes tumor. No metastases were found. The second patient had a very fast growing phyllodes tumor that at the time of operation had grown to 14 cm's. At operation there proved to be a small localized area of DCIS grade 2. The rest of the lesion however was still benign. The pathologist told us that differentiation between a fibroadenoma and a benign phyllodes tumor can be very difficult no matter the size of the biopsy needle.

For more cases of benign phyllodes tumors and other types of malignant breast tumors see

Copyright © Dr. T.S.A. Geertsma, Ziekenhuis Gelderse Vallei, Ede, The Netherlands. All rights reserved.

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