Coexistence of benign phyllodes tumor and invasive ductal carcinoma in distinct breasts: case report

Phyllodes tumors represent a rare biphasic neoplasm composed of epithelial and stromal elements, which corresponds to a total of 1% of breast cancers and around 2% to 3% of fibroepithelial tumors [1,2]. The concomitance of these tumors with epithelial malignant neoplasms is rare. The literature reported the association of phyllodes tumors with malignant epithelial components mainly in the form of ductal or lobular in situ lesions and less often in the invasive form. However, they are usually situated inside the lesion or near the fibroepithelial neoplasm tissue [3].Treatment of these tumors depends on the epithelial and fibroepithelial lesion intrinsic profile. Excision of the lesion with margins is considered to be adequate in benign phyllodes tumors cases. On the other hand, when the phyllodes tumors are large, a simple mastectomy is recommended. In the case of epithelial injury, size, location and lymph node involvement are not considered in determining therapeutic approaches [3-5].Carcinoma is the medical term for the most common type of cancer occurring in humans [6-8]. The synchronous coexistence of benign phyllodes tumor in one breast and invasive carcinoma in the other breast is rare. In fact, we found no reports in the literature documenting the association of phyllodes tumor and invasive ductal carcinoma. To our knowledge, this is the first report to describe a case of synchronous coexistence of benign phyllodes tumor and invasive ductal carcinoma in distinct breasts.This is a 66-year-old patient, with four pregnancies, three normal deliveries and one abortion. She smoked from the ages of 10 to 51？years and had no family history of breast carcinoma. She reported the presence of progressively growing nodules in both breasts in 2005. In 2006, she underwent a mammography (Figure 1) with suspicious findings and was referred to the hospital. She did not visit the hospital for fear of a positive diagnosis. In December 2006, she underwent another mammography, and