Rapidly Progressive Giant Malignant Phyllodes Tumor of the Breast: A Surgical Challenge

Malignant phyllodes tumors are rare fibroepithelial breast neoplasms that may pose significant diagnostic and surgical challenges, particularly when they reach extreme dimensions. Complete surgical excision with adequate margins remains the cornerstone of treatment. We report the case of a 65-year-old female who presented with a progressively enlarging mass of the left breast over an 18-month period. Clinical examination revealed a massive palpable lesion occupying nearly the entire breast, resulting in marked distortion of the breast architecture. Due to the extensive size of the tumor, conventional imaging modalities could not be adequately performed. Core needle biopsy demonstrated findings consistent with a malignant phyllodes tumor. The patient subsequently underwent left mastectomy, and histopathological examination confirmed complete excision of a 29 × 26 × 17 cm mass with negative, adequate margins. Eight months postoperatively, a local recurrence was identified along the mastectomy scar. The patient underwent wide local excision of the recurrent lesion followed by flap reconstruction. At three-year follow-up, the patient remains free of disease recurrence.