On the 04/01/15, a 38 years old Malay lady with no known medical illness presented to the Emergency Department of Hospital Universiti Sains Malaysia, with the chief complain of Left breast swelling. Further history revealed, swelling was there for past 5 years, which initially approximate a size of tennis ball and gradually increased in size to the present size of 25cm by 15cm. The reason she sought for medical treatment was ulceration on the swelling with foul smelling discharge and throbbing pain which limited her range of movement of the left upper limb for the past 2 months.
The patient denies of having any history of fever and loss of appetite but experienced some lost of weight recently. She was married at the age of 25, nulliparous…show more content… Ultrasound, mammography and MRI are common imaging that has been utilized in case of Phyllodes. However these modalities are failed to differentiate between benign and malignant Phyllodes tumor. Furthermore presentation at advance stage with bulky tumor and ulcerated surface as in our case, become barrier for the patient to undergo imaging prior to surgery. Therefore histopathological findings remain crucial in making definitive diagnosis of Phyllodes tumor and classify them into benign, borderline malignant and malignant.
Histopathologically phyllodes defined as mixed epithelial and stromal or mesenchymal proliferation of breast characterized by increased stromal cellularity and characteristic broad "leaf-like" papillae inserted into cleft-like spaces. Fine needle aspiration cytology is routinely used technique to differentiate benign from malignant breast cancer.
However, fibroadenoma and phyllodes tumor cannot be differentiated using this technique due to insufficient cytological samples and heterogenous nature of the tissue in phyllodes. Therefore, definitive diagnosis can be made once the entire lesion surgically removed and send for histopathology