Malignant phyllodes tumour presenting as a massive fungating breast mass and silent thrombo-embolism.
BACKGROUND
We report an unusual case of a massive malignant phyllodes tumour that had almost replaced the entire breast presenting with severe chronic blood loss, extensive deep venous thrombosis (DVT) and a silent pulmonary embolus.


METHODS
Long-standing neglected massive fungating ulcerative mass larger than the left haemothorax.


CONCLUSIONS
Phyllodes tumours are rare fibro-epithelial breast lesions that have the propensity to grow rapidly to a large size if neglected. Larger tumours are more likely to be malignant with an overall metastatic rate around 10%. An incidental pulmonary embolus arising from extensive silent lower limb deep vein thrombosis requiring an IVC filter complicated the surgical management.


CONCLUSIONS
Phyllodes tumours are rare and account for approximately 0.3-0.5% of all breast tumours [1]. They have the propensity to be fast growing. However, tumours reaching a massive size (>10cm) are rare with few reports in the literature.
Department of Radiology, Sir Charles Gairdner Hospital, Australia. Electronic address: Anita.Bourke@health.wa.gov.au.
Anita G
AG
Bourke
Department of General Surgery, Sir Charles Gairdner Hospital, Australia.
Madeleine
M
McCreanor
Department of General Surgery, Sir Charles Gairdner Hospital, Australia.
Allen
A
Yeo
Department of General Surgery, Sir Charles Gairdner Hospital, Australia.
Dieter
D
Weber
Department of Radiology, Sir Charles Gairdner Hospital, Australia.
Anthony
A
Bartlett
PathWest, Sir Charles Gairdner Hospital, Australia.
Anastasia
A
Backhouse
Breast; Malignant; Phyllodes; Thromboembolism; Tumour