Clinical Report: Bilateral Synchronous Phyllodes Tumors with Differing Grades

Overview

This report discusses a rare case of synchronous bilateral phyllodes tumors in a 44-year-old woman, highlighting the diagnostic challenges posed by 18F-FDG PET-CT imaging. The findings emphasize the importance of clinicopathologic correlation in managing phyllodes tumors, particularly regarding axillary lymph node assessment.

Background

Phyllodes tumors are rare fibroepithelial neoplasms of the breast, accounting for a small percentage of breast tumors. Their variable biological behavior and potential for local recurrence or metastasis necessitate careful management. Synchronous bilateral phyllodes tumors are exceptionally rare, complicating diagnosis and treatment, particularly when imaging may misinterpret reactive changes as malignancy.

Data Highlights

Key Findings

Clinical Implications

Clinicians should be cautious when interpreting 18F-FDG PET-CT results in the context of phyllodes tumors, as reactive changes may mimic metastasis. Surgical management should prioritize complete excision with negative margins, and axillary surgery should be guided by clinical and pathological findings rather than imaging alone.

Conclusion

This case underscores the complexities of diagnosing and managing synchronous bilateral phyllodes tumors, particularly regarding imaging interpretation and axillary assessment. A multidisciplinary approach is essential for optimal patient outcomes.

References

1. UK Association of Breast Surgery, 2025 -- Contemporary management of phyllodes tumours of the breast: recommendations
2. Springer, 2025 -- Imaging Findings Indicating Pectoral Nerve Involvement in Perineural Metastasis of Breast Cancer to the Brachial Plexus
3. Springer, 2024 -- Key Imaging Guidelines for Lymphoma: Recommendations from the European Society of Oncologic Imaging
4. Springer, 2024 -- Guidelines for Staging and Restaging in Oncology Using FDG-PET/CT
5. Utilizing Hybrid SPECT/CT for Enhanced Lymphatic Mapping in Breast Cancer Patients
6. Contemporary management of phyllodes tumours of the breast: recommendations from the UK Association of Breast Surgery
7. UK guidelines for the management of soft tissue sarcomas | British Journal of Cancer
8. https://ejbc.kr/pdf/10.4048/jbc.2024.0284