Breast tumor with giant phyllodes: a case report

Background: Giant phyllodes tumors are rare and are characterized by rapid growth and abundant vascularity. Intraoperative hemorrhage constitutes a major surgical challenge. This report describes a case of a 36-year-old woman with a giant phyllodes tumor of the breast, along with the corresponding treatment strategy.

Case Description: A 36-year-old woman presented with a right mass for 2 years. Mammography showed a mass measuring 178 mm × 113 mm in the right breast, which was categorized as Breast Imaging Reporting and Data System (BI-RADS) 4C. Core needle biopsy suggested a possible phyllodes tumor. Following multidisciplinary team (MDT) consultation and recommendations from specialists in oncology and plastic surgery experts, preoperative embolization of the main feeding arteries was performed to minimize intraoperative hemorrhage, followed by intraoperative circumferential suture ligation of subcutaneous blood vessels. A mass weighing 4.42 kg was completely resected. Postoperative pathology showed extensive hemorrhagic degeneration and infarction of the tumor, with focal brisk stromal cellular proliferation; borderline change could not be excluded. The patient’s postoperative recovery was uneventful.

Conclusions: The “two-step” hemostatic strategy combining preoperative arterial embolization and intraoperative circumferential suture ligation can effectively reduce intraoperative bleeding in patients with giant phyllodes tumors. This approach is thus both feasible and safe for similar cases.