Bilateral Synchronous Phyllodes Tumors with Differing Grades and Misleading Axillary 18F-FDG PET-CT Uptake: A Case Study and Review of the Literature

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Phyllodes tumors are rare breast neoplasms, with synchronous bilateral cases being exceptionally uncommon.
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A 44-year-old woman presented with a rapidly enlarging, painful left breast mass and a clinically occult right breast lesion.
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18F-FDG PET-CT showed intense uptake in the left breast mass, raising concerns for metastasis, but final pathology revealed no nodal metastasis.
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Management included complete excision of both tumors and axillary lymph node dissection, emphasizing the need for negative margins.
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Marked axillary FDG uptake may indicate reactive inflammation rather than metastasis, highlighting the importance of clinicopathologic correlation.

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