Giant Fibroadenoma-Radiologically Simulating Phyllodes Tumor: A Case Report of Unresolved Diagnostic Enigma

Fibroadenoma and phyllodes tumor are fibroepithelial lesions, thus may have similar histopathological appearance and share overlapping clinical as well as radiological features. The distinction between these two lesions is clinically important as both lesions have different management. There is substantial overlap between fibroadenomas and phyllodes tumors. We present a similar case report of a 23 years-old female patient with classical radiological features of phyllodes tumor, which turned out to be a giant type of fibroadenoma on histopathology after surgical excision.

Keywords: Giant fibroadenoma; Phyllodes; Mammography; Ultrasound; MRI

Abbreviations: BIRADS: Breast Imaging-Reporting and Data System

Introduction

Fibroadenoma is a benign lesion, accounting for well over half of breast tumors, while phyllodes tumor have spectrum of diseases ranging from benign to malignant lesions, accounting for 1% of all breast neoplasms [1]. Fibroadenoma and phyllodes tumor are fibroepithelial lesions [2], thus may have similar histopathological appearance and share overlapping clinical as well as radiological features [3,4]. The distinction between these two lesions is clinically important as the both lesions are managed differently. Fibroadenoma may be closely followed up or treated with simple enucleation, while phyllodes tumors must be surgically excised with wide excision and adequate margins to avoid local recurrence and subsequent surgery [5,6].

Most studies have reported differentiating fibroadenomas and phyllodes tumors radiologically on the basis of their shape and margins. While phyllodes tumours are lobulated in shape, fibroadenomas are frequently oval in shape with well circumscribed margins. Hypervascularity is often associated with phyllodes tumor, whereas fibroadenomas are hypo-vascular [3]. In spite of these well recognised and reported differentiating radiological features, there is a substantial imaging overlap between fibroadenomas and phyllodes tumors [7,8]. We present a similar case of a 23 years-old female patient with well reported radiological features of phyllodes tumor, which turned out to be a giant type of fibroadenoma on histopathology after surgical excision of the lesion.

 

Read More About This Article: 10.31031/IGRWH.2020.03.000570

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