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<p>Phyllodes tumors are fibroepithelial neoplasms accounting for less than 1% of all breast tumors, typically appearing in women in 40s or 50s. The World Health Organization classifies them as benign, borderline, or malignant. Giant phyllodes are those which are over 10&#xa0;cm, accounting for about 20% of cases, with very few reported in literature. Surgery remains the mainstay of treatment for phyllodes tumors of all types. We report a case of a 19-year-old girl with a 40 × 35&#xa0;cm recurrent left breast malignant phyllodes tumor. A radical mastectomy was performed safeguarding the axillary vessels and brachial plexus to achieve negative margins, the defect created was covered using a free anterolateral thigh (FALT) and tensor fascia lata (TFL) flap. The flap healed uneventfully, and patient received chest wall radiotherapy subsequently. The average size of a patient presenting with a phyllodes lump is 4–5&#xa0;cm. Adequate surgical excision with good margins is the mainstay of treatment. The excision of larger tumors is often challenging as it requires a wide excision of overlying skin and underlying muscle,&#xa0;often requiring&#xa0;large reconstructions with microvascular&#xa0;free flaps, calling for oncological safe resection&#xa0;and plastic surgical skill for achieving&#xa0;cure&#xa0;effectively. To the best of our knowledge, this fungating tumor measuring. We report a 40&#xa0;cm&#xa0;recurrent, malignant phyllodes tumour as one&#xa0;among the largest resectable phyllodes tumor reported in literature and was reconstructed with a conjoint FALT + TFP perforator flap.</p>

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Successful Surgical Management of a Giant, Recurrent Malignant Phyllodes Tumor

  • 期刊论文

  • 发表日期：

    2025年7月15日

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  • Rhea Sarkari,
  • Narayanan Rajavelu,
  • Shalaka Joshi,
  • Dushyant Jaiswal

摘要

Phyllodes tumors are fibroepithelial neoplasms accounting for less than 1% of all breast tumors, typically appearing in women in 40s or 50s. The World Health Organization classifies them as benign, borderline, or malignant. Giant phyllodes are those which are over 10 cm, accounting for about 20% of cases, with very few reported in literature. Surgery remains the mainstay of treatment for phyllodes tumors of all types. We report a case of a 19-year-old girl with a 40 × 35 cm recurrent left breast malignant phyllodes tumor. A radical mastectomy was performed safeguarding the axillary vessels and brachial plexus to achieve negative margins, the defect created was covered using a free anterolateral thigh (FALT) and tensor fascia lata (TFL) flap. The flap healed uneventfully, and patient received chest wall radiotherapy subsequently. The average size of a patient presenting with a phyllodes lump is 4–5 cm. Adequate surgical excision with good margins is the mainstay of treatment. The excision of larger tumors is often challenging as it requires a wide excision of overlying skin and underlying muscle, often requiring large reconstructions with microvascular free flaps, calling for oncological safe resection and plastic surgical skill for achieving cure effectively. To the best of our knowledge, this fungating tumor measuring. We report a 40 cm recurrent, malignant phyllodes tumour as one among the largest resectable phyllodes tumor reported in literature and was reconstructed with a conjoint FALT + TFP perforator flap.