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Scripta Scientifica Vox Studentium


Dragostina Tsocheva, Katerina Marinova, Borislav Petrov, Rumen Nenkov, Radoslav Radev


Introduction: Phyllodes tumors, also known as cystosarcoma phyllodes (CSP) are rare fibroepithelial   tumors with an incidence of 0.3-1.0% of all breast neoplasms. They tend to be large, very fast-growing breast tumors, the size of which reaches 10-20 centimeters. Phyllodes tumors may be considered benign, borderline and malignant (10-25%) depending on their histological features and structure. Clinically CSP can lead to the deformation of the breast as well as to ulceration and inflammation of the overlying skin.

Materials and Methods: We present a case report of a 48-year-old woman D.Y. who has been admitted and treated several times in different hospitals. In our Clinic of Thoracic Surgery in St. Marina University Hospital she presented with symptoms of extremely enlarged and painful left breast, leak of purulent secretion with a fetid smell. After a physical examination the following changes were discovered: greatly increased size of the left breast (about 70 centimeters), redness and swelling. A presence of a cutaneous fistula projecting over the skin with plenty of quantity putrid fabrics was established in the upper medial quadrant . After the diagnostic process at the Thoracic Clinic , the physicians determined that this formation was phyllodes tumor with a giant size. The patient was assessed and scheduled for a radical operative intervention.

Results: Intraoperatively, a giant tumor in decay with a size of about 35/40 cm was established. The tumor formation was extirpated by harmonic scalpel and followed by a plastic reconstruction of the breast.  During the postoperative period suppuration was not observed. After the control examination, there were no signs of deformation or risk of local recurrence.

Conclusion: In this case, because of the beginning of necrosis in the tumor, the patient was wrongly diagnosed and treated for chronic mastitis in the past.


phyllodes tumor, breast, surgery



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