Fibromatosis-like metaplastic carcinoma with aggressive metastasis and a TERT promoter mutation: a case report and literature review

This case highlights that a subset of FLMCa may exhibit unexpectedly aggressive behavior and resistance to conventional therapy. The presence of a TERT promoter mutation suggests a potential molecular mechanism for this virulence. Our findings advocate for a re-evaluation of risk stratification in FLMCa and underscore the critical need for vigilant follow-up and molecular profiling to guide future targeted therapy strategies.