Revolutionizing Breast Surgery: A Case Report on the Excision of a Large Fibroadenoma Suggestive of Phyllodes Tumor Under Thoracic Spinal Anesthesia

Fibroadenomas are benign breast tumors, typically affecting middle-aged women, with rapid growth in some cases leading to compression of surrounding structures and presenting a clinical challenge. This case illustrates the successful use of thoracic spinal anesthesia (TSA) for excising a large fibroadenoma with characteristics suggestive of a phyllodes tumor, a procedure traditionally conducted under general anesthesia (GA). The anesthesia was administered using 1.5 ml of 0.5% isobaric levobupivacaine and 5 micrograms of dexmedetomidine, complemented by an ultrasound-guided erector spinae plane block (ESPB) for postoperative analgesia. The patient experienced minimal hemodynamic fluctuations and achieved immediate postoperative mobilization. This case underscores TSA as a safe, effective alternative to GA, particularly beneficial in patients with respiratory considerations, offering stable intraoperative conditions and rapid recovery.