title: Adrenal metastasis of a phyllodes tumor of the breast: Case report and review of the literature.
abstract: BACKGROUND
  A phyllodes tumor is a neoplasm of mixed mesenchymal and epithelial origin affecting the breast. It may pursue a benign or malignant evolution with distant metastases in the latter case. Sites most commonly affected by metastases are the lungs and bones. Simple mastectomy is the mainstay of treatment. This article presents the first described case of metastasis to the adrenal gland after sarcomatous transformation of a phyllodes tumor. A review of the literature is presented afterwards.
  
  
  METHODS
  A 57-year old female patient presented with a voluminous breast mass which was completely resected. Unfortunately she presented with malignant recurrence in the breast which was also resected. A later recurrence within the lung presented and was completely resected but showed aspects of sarcomatous changes. Finally a recurrence was pathologically documented within the adrenal gland. Unfortunately, disease later progressed and the patient refused further treatment at that point.
  
  
  CONCLUSIONS
  While malignant transformation of breast phyllodes tumors and metastasis is relatively common, the prognosis for initially benign lesion that are completely excised is usually good. This case represents the first documented metastasis to the adrenal gland of a breast phyllodes tumor.
  
  
  CONCLUSIONS
  We presented the first case of adrenal metastasis of a phyllodes tumor after sarcomatous degeneration. This is an unusual presentation of a relatively uncommon but well-recognized disease of variable malignant potential.
authors.affiliation: Department of Surgery, Université de Sherbrooke, Sherbrooke, Canada. Electronic address: yves.collin@usherbrooke.ca.
authors.forename: Yves
authors.initials: Y
authors.lastname: Collin
authors.forename: François
authors.initials: F
authors.lastname: Chagnon
authors.forename: Charles J
authors.initials: CJ
authors.lastname: Mongeau
authors.forename: Gonzalo L
authors.initials: GL
authors.lastname: Gonzalez-Amaya
authors.forename: Lucas
authors.initials: L
authors.lastname: Sideris
keywords: Breast surgery; Breast tumor; CT; Computerized tomodensitometry; Phyllodes tumor