Cutaneous presentation of a distant metastasis of malignant phyllodes tumor

Cutaneous Scalp Metastases of Malignant Phyllodes Tumor of the Breast

Phyllodes tumor (PT) of the breast is a relatively rare fibroepithelial tumor that accounts for < 1% of primary breast neoplasms. PT is classified histologically as benign, borderline, or malignant, and a malignant PT has greater potential to metastasize than benign PT. Although almost all other organs can be affected, common metastatic sites are the lung and bone via the hematogenous route. There have been several studies reporting cutaneous and soft tissue metastases of PT, though the incidence is rare. Herein, we report a very rare case of scalp metastasis of malignant PT that was diagnosed via skin biopsy and surgical excision.

Palliative treatment of metastatic phyllodes tumors: a case series

Up to 20% of malignant phyllodes tumors (PT) metastasize, most frequently to the lungs, bone, and brain. Descriptions of metastatic PT are limited in the literature. In this series, we present three cases of malignant PT metastatic to various unusual sites including the peritoneum, soft tissue of the thigh, and scalp. All three patients initially received surgical resections, and two underwent adjuvant radiation. All three patients developed lung metastases first. Several palliative modalities were used including surgical resection, gamma-knife stereotactic radiosurgery, external beam radiation, and chemotherapy. All three patients died within 3 years of the initial diagnosis.

Invasive duct carcinoma of the forearm: a rare case of distant, isolated 'carcinoma en cuirasse'

Cutaneous metastasis (carcinoma en cuirasse) is a condition that results from a tumor spreading via lymphatic or vascular embolization, direct implant during surgery or skin involvement by contiguity. Contralateral distant cutaneous breast cancer has never been reported before and hence, the nature and management of such rare cases remains challenging. We aim to present a case of left-sided 'distant' cutaneous metastatic invasive duct carcinoma affecting the distal upper extremity (contralateral side) two and half years (disease-free) following treatment for right breast cancer (right mastectomy + chemoradiation). A complete metastatic work-up excluded the presence of any underlying disease. Clinical examination revealed a fungating, irregular ulcer that bled easily on touch involving the left forearm. The ulcer was excised totally and the raw area reconstructed using a split thickness graft. The patient had uneventful postoperative course and now remains disease-free for almost 1 year with no evidence of local recurrence.

Primary malignant fibrous histiocytoma of the breast: report of one case

Seven years ago, a 48-year-old female patient discovered a painless tumor in her right breast simply by chance. In the next year, the tumor increased significantly in size. At this point, the patient received a tumor resection, which was misdiagnosed as a benign mesenchymal tissue-originated tumor. Unfortunately, the tumor recurred just 10 days after resection. We subsequently resected the recurrent lesion and confirmed primary breast malignant fibrous histiocytoma. The tumor began to exhibit an unprecedented, massive, and uncontrolled growth, ulcerating soon after the operation. Treatment of the patient was limited by time. After the patient received a cycle of chemotherapy, she died of cachexia with the emergence of multiorgan metastasis 2 months after the operation.