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Arch Surg. 2008;143(2):208.

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Answer: Phyllodes tumor (benign)

Originally described by Johannes Muller in 1838, phyllodes tumors comprise less than 1% of all breast tumors.¹ Although they closely resemble fibroadenomas, they are distinguished by larger size, rapid growth, and late occurrence. The overlying skin may show dilated veins, bluish discoloration, and, rarely, pressure necrosis, although frank ulceration is uncommon.² Rarely, pressure necrosis of the overlying skin can occur with a huge benign phyllodes tumor,³ more so in a small breast. This, coupled with the growth stimulus of pregnancy, can cause extrusion of the tumor through the skin, as was seen in the present case. When it extrudes out of the skin, the exophytic lump can be mistaken for an aggressive malignant tumor. About 40% manifest estrogen receptors, and almost 100% are progesterone receptor positive,⁴ which explains their rapid growth during pregnancy. Mammographic features resemble those of a fibroadenoma. On fine-needle aspiration cytological examination, cohesive stromal cells, mesenchymal cells, . . . [Full Text of this Article]

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Arch Surg. 2008;143(2):207.
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