A case of a giant phyllodes tumour of the breast

Phyllodes tumour appears with the frequency of 0.5-1% of all breast cancers. It is diagnosed in women between 30 and 70 years old. The name comes from the appearance of the tumour, which in cross-section resembles the head of a cabbage. Phyllodes tumour is a seldom diagnosed tumour among breast cancers. It consists of epithelial elements, which show features of histopathological malignant and mesenchymal parts which condition the clinical course of the disease. The tumours are histopathologically classified into benign, borderline and malignant tumours. The article presents the case of a 41-year-old patient, sent to the Clinic of Surgery of the 10th Military Clinical Hospital in Bydgoszcz because of a giant tumour of her right breast. On admission to hospital the patient was in a serious condition. The woman’s body was ravaged by the disease. For three months she had been bedridden and treated symptomatically with narcotic analgesics. In additional investigations: anaemia (8 g/dl), lowered level of total protein and albumins, paroxysmal hypoglycaemia. Locally there was a giant, decaying tumour in the right breast. It was 40 cm in diameter with ulceration and clinically enlarged lymph nodes of the right armpit. The patient was qualified for surgery on an urgent basis. A mastectomy was performed by Madden’s method with oncoplastic surgery, on account of the extensive tumour. The postoperative course was uneventful. Phyllodes tumour was diagnosed in the postoperative pathological examination – in the central part of the tumour there was weaving of the malignant mesenchymal tumour type, without features of metastases in lymph nodes of the armpit. After a month of hospitalization at the Surgical Clinic the patient was transferred for further rehabilitation. One year after the surgery the woman, in good general condition and without any clinical signs of relapse, remains under oncological observation.