Life threatening bleeding from untreated phyllodes tumor following earthquake induced follow up delay

Year 2025, Volume: 16 Issue: 55, 116 - 119, 18.08.2025

Ozan Utku Öztürk

https://doi.org/10.17944/interdiscip.1652900

Abstract

Phyllodes tumors, representing 0.3%–0.5% of breast masses, are infrequent and sophisticated neoplasms of the breast. Based on their histological features, they are classified into three categories: benign, borderline, or malignant; preoperative diagnosis is challenging, and surgical removal with clear margins is the primary treatment option. This report describes the case of a 35-year-old woman whose longstanding breast mass underwent rapid transformation. The patient missed her follow-up appointment due to the February 6, 2023, earthquake in Hatay and presented with hemorrhagic shock from bleeding caused by the tumor eroding the internal thoracic artery.

Keywords

Phyllodes tumor, breast tumor, hemorrhage, emergency surgery

References

• Liang MI., Ramaswamy B, Patterson CC, et al. Giant breast tumors: surgical management of phyllodes tumors, potential for reconstructive surgery and a review of literature. World J Surg Oncol 2008;6:117. DOI: 10.1186/1477-7819-6-117
• Lawton TJ, Argani P, Goldstein N, et al. Interobserver variability by pathologists in the distinction between cellular fibroadenomas and phyllodes tumors. Int J Surg Pathol 2014;22:695-8. DOI: 10.1177/1066896914548763
• Wurdinger S, Marx C, Herzog AB, Fischer DR, Schneider A, Raabe G, Kaiser WA. Differentiation of Phyllodes Breast Tumors from Fibroadenomas on MRI. AJR Am J Roentgenol 2005;185:1317-21. DOI: 10.2214/AJR.04.1620
• Reinfuss, M., Mituś, J., Duda, K., Stelmach, A., Ryś, J. and Smolak, K. The treatment and prognosis of patients with phyllodes tumor of the breast: An analysis of 170 cases. Cancer 1996;77:910-6. DOI: 10.1002/(SICI)1097-0142(19960301)77:5<910::AID-CNCR16> 3.0.CO;2-6.
• Matsushima H, Matsushima H, Kikuchi M, Miyabe R, Atsuta K, Shintan T. Emergency Resection of a Bleeding Ruptured Malignant Phyllodes Tumor of the Breast. Cureus 2024;16(1):e52775. DOI: 10.7759/cureus.52775
• Meher S, Mishra TS, Sasmal PK, Rath S, Sharma R. An Ulcerated Giant Malignant Phyllodes Tumour Presenting in Septic Shock. J Clin Diagn Res 2016;10(12): PJ01-PJ02. DOI: 10.7860/JCDR/2016/20252.8945
• Nabi J, Akhter SQ, Authoy FN. A Case of Large Phyllodes Tumor Causing “Rupture” of the Breast: A Unique Presentation. Case Rep Oncol Med 2013;2013:871292. DOI: 10.1155/2013/871292
• Bruce NR, Carlson J, Barnard KJ, Henry-Tillman R. Phyllodes tumor masquerading as a fungating breast mass. J Surg Case Rep 2017;2017(12):rjx220. DOI: 10.1093/JSCR/RJX220
• Ditsatham C, Somwangprasert A, Watcharachan K, Wongmaneerung P. “Ruptured” malignant phyllodes tumor of the breast: a case report. Int Med Case Rep J [Internet] 2016;9:35–7.DOI - 10.2147/IMCRJ.S96115
• Wijeyaratne SM. Breast “rupture” due to a phyllodes tumour. BMJ Case Rep 2010; 2010:bcr0320102790. DOI: 10.1136/BCR.03.2010.2790
• Yang M, Cui RBJ, Perera R. Emergency resection of large, ulcerating phyllodes tumour with active bleeding. ANZ J Surg. 2022;92(3):601-2. DOI: 10.1111/ANS.17110
• Cantürk AÖ. Unexpected Clinical Status of Phyllodes Tumor of the Breast: Massive Bleeding. Cureus 2024; 16(8):e65923. DOI: 10.7759/cureus.65923
• Barth RJ, Wells WA, Mitchell SE, Cole BF. A prospective, multi-institutional study of adjuvant radiotherapy after resection of malignant phyllodes tumors. Ann Surg Oncol 2009;16(8):2288-94. DOI: 10.1245/S10434-009-0489-2