A CASE OF GIANT MALIGNANT PHYLLODES TUMOR OF THE BREAST PERFORMED EXTENDED RADICAL MASTECTOMY WITH WIDE EXCISION OF THE THORACIC WALL

We report a case of giant phyllodes tumor of the right breast invading the whole layer of the thoracic wall. A 45-year-old woman was admitted to the hospital because of a giant breast tumor 30 cm in diametter fixed on her chest wall. The tumor ulcerated and tended to bleed. It smelled bad due to sssociated infection with MRSA and Pseudomonas aeruginosa. In chest CT and MRI, invasion of the tumor into the chest wall was suspected. Extended radical mastectomy and chest wall resection associated with reconstruction by using Marlex mesh and a contralateral rectus abdominaris musculocutaneous flap were performed. Intraoperative findings showed the invasion of the tumor into the chest wall. The excised tumor was 2500 g in weight. Some distinctive gaps were revealed in specimen of the tomor. Microscopic appearance of the tumor showed malignant phyllodes tumor with low grade malignancy. Tamoxifen 20 mg was administered postoperatively to avoid recurrence. The patient was discharged from the hospital 91 days after the operation.