Giant malignant phyllodes tumor with ulceration: A case report and brief review of the literature

A phyllodes tumor (PT) is a rare breast neoplasm characterized by variable biological behavior, ranging from benign to malignant. A number of PTs exhibit a rapid growth and are classified as fibroepithelial tumors with a notable risk of local recurrence. Of note, ~10‑15% of cases are malignant and may recur locally in up to 30% of instances. The present study describes a case of a rapidly growing, giant, ulcerative malignant PT. A 40‑year‑old female patient presented with a rapidly enlarging left breast mass over period of 2 months. An examination revealed a hard, irregular, fixed mass measuring ~24x20x17 cm, with a skin ulceration. She underwent a wide local excision followed by adjuvant radiotherapy. Histopathological analysis confirmed a malignant PT with myoid differentiation. At the 1‑year follow‑up, recurrent PT was diagnosed, and a modified radical mastectomy was performed. In a review of the literature, a total of seven case reports on malignant PTs of the breast were identified. The patients were all female, with ages ranging from 19 to 73 years. Of note, 5 of the cases involved tumors in the right breast, while 2 cases involved tumors in the left breast. Tumor sizes varied widely, from 7.5x7x4.5 cm to as large as 55.5x36x50 cm. The diagnosis and management of malignant PTs may be challenging due to their rarity and unpredictable clinical behavior. Even with aggressive treatment, these tumors carry a significant risk of recurrence, highlighting the importance of vigilant clinical follow‑up and multidisciplinary care.