title: Giant malignant mammary phyllodes tumor: report of a case and review of the literature.
abstract: BACKGROUND
  To distinguish between a benign and malignant phyllodes tumor before surgery is difficult. Wide excision or mastectomy with adequate free margins is necessary in the case of a malignant phyllodes tumor. However, repairing the skin defect after removal of a giant malignant phyllodes tumor is a great challenge for the breast surgeon.
  
  
  METHODS
  We report the case of a 45-year-old Taiwanese woman with a giant malignant phyllodes tumor measuring 30 x 25 x 22 cm. Prior to surgery, we carefully designed a flap to cover the skin defect, following standard mastectomy with at least 2 cm free margins. Postoperatively, the patient recovered well without any wound infection or flap necrosis. During follow-up at our outpatient department, there was no evidence of local relapse or distant metastasis.
  
  
  CONCLUSIONS
  Giant malignant phyllodes tumors can be treated by total mastectomy with adequate free margins, using a flap technique to cover the skin defect.
authors.affiliation: Division of General Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC.
authors.forename: Sheng-Der
authors.initials: SD
authors.lastname: Hsu
authors.forename: Shao-Jiun
authors.initials: SJ
authors.lastname: Chou
authors.forename: Huan-Fa
authors.initials: HF
authors.lastname: Hsieh
authors.forename: Teng-Wei
authors.initials: TW
authors.lastname: Chen
authors.forename: Ming-Fang
authors.initials: MF
authors.lastname: Cheng
authors.forename: Jyh-Cherng
authors.initials: JC
authors.lastname: Yu
mesh_terms: D001943:Breast Neoplasms / Q000145:classification / Q000175:diagnosis* / Q000601:surgery*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D015413:Mastectomy, Simple / Q000379:methods*; D008875:Middle Aged; D003557:Phyllodes Tumor / Q000145:classification / Q000175:diagnosis* / Q000601:surgery*; D013524:Surgical Flaps; D016896:Treatment Outcome