Investig Magn Reson Imaging.  2024 Dec;28(4):202-206. 10.13104/imri.2024.0024.

Invasive Ductal Carcinoma Within a Borderline Phyllodes Tumor Associated With Extensive Ductal Carcinoma In Situ: A Case Report

• Kim WH
• Lee KH
• Oh HE
• Seo BK
• Bae MS

• KMID: 2563829
• DOI: http://doi.org/10.13104/imri.2024.0024

Abstract

Phyllodes tumors of the breast are rare biphasic fibroepithelial neoplasms that may coexist with breast carcinomas. Herein, we report a case of invasive ductal carcinoma (IDC) within a borderline phyllodes tumor accompanied by extensive ductal carcinoma in situ (DCIS) in the same breast. A 72-year-old woman presented with a palpable lump in the right breast. Mammography showed an oval mass associated with segmental microcalcifications, and breast ultrasound (US) revealed a 2.3 cm oval mass and an associated non-mass lesion. Based on US-guided core needle biopsy, the initial biopsy result of the non-mass lesion suggested DCIS; however, the mass was diagnosed as a fibroepithelial lesion. Preoperative dynamic contrast-enhanced magnetic resonance imaging showed a rim-enhancing oval mass with areas of T2 hyperintensity, accompanied by segmental non-mass enhancement. The mass was highly suspicious for malignancy and was considered imaging-pathology discordant. Subsequently, the patient underwent mastectomy. Histopathological examination of the surgical specimens confirmed a borderline phyllodes tumor with an IDC within the tumor and an extensive intraductal component. The invasive carcinoma component was triplenegative breast cancer. This case highlights the diagnostic challenges of identifying coexisting carcinomas within phyllodes tumors and emphasizes the necessity for increased awareness among radiologists regarding this possibility.

Keyword

Phyllodes tumor; Breast cancer; Invasive ductal carcinoma; Magnetic resonance imaging