Biomed Imaging Interv J 2006; 2(4):e45-28
doi: 10.2349/biij.2.4.e45-28
© 2006 Biomedical Imaging
and Intervention Journal
ABSTRACT
Case Presentation from Various Countries: Case from Indonesia
Daniel Makes 1, Henry Naland 2, Esti Soetrisno 3
1 Department of Radiology, Faculty of Medicine, University of Indonesia, Indonesia
2 Department of Surgery, Mitra International Hospital, Indonesia
3 Department of Pathology Anatomy, Faculty of Medicine, University of Indonesia, Indonesia
A woman, 47 years old, noted a small lump on her left breast since one year ago and one week prior hospital admission she noted that there was an ulceration on the upper-outer quadrant of her breast.
She was admitted to the hospital on May 6, 2006 and her clinical finding : A huge mass was occupied on the left breast, 30x30x25 cm in size and an ulcer was identified on the mid-lateral quadrant with 4x3 cm in diameter. The axillary, supra and infraclavicular lymphnodes are not palpable All laboratory results were within normal limits except for her HB which is a slightly low ( 11,6 g/dl ). Her CEA: 0,9 and CA 15.3 was 10. The chest X-ray and Bone scan were normal in appearances, no sign of metastasis can be seen in the lung or bones. Mammography was not done because of huge tumor with ulceration, and she underwent breast ultrasound with color Doppler interrogation. The ultrasound examination revealed A huge phyllodes tumor with an multiple area of hypervascularisation, malignant degeneration can not be ruled out. The surgeon suggest to do simple mastectomy but the patient refused that procedure asking for preserved her breast. She underwent surgery on May 11,2006 with wide excision and frozen section revealed benign phyllodes tumor. The surgeon applied breast reconstruction with modified McKissock procedure. She discharged from the hospital on May 14, 2006 and post surgery she is going well. On routine check-up dated September 25, 2006 we found a nodule on the medial-superior quadrant of her left breast , 3 cm in diameter and color Doppler US revealed a lobulated solid lesion with relatively hypervascularisation, we considered this as a recurrences of her phyllodes tumor The surgeon is planning to do subcutaneous mastectomy and breast reconstruction with Silicon breast prosthesis.
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