Case report.
CASE REPORT: A 58-year-old black female patient was referred to the Mastology unit of the Department of Gynecology, Federal University of São Paulo / Escola Paulista de Medicina, in February 1990, presenting an ulcerated
tumor in the right breast with fast growth over the preceding six months. She was a virgin, with meno-pause at the age of 45 years and had not undergone
hormone replacement treatment. The physical examination showed, in her right breast, an ulcerated
tumor of 20 x 30 cm which was not adher-ent to the muscle level, multilobular and with fibroelastic consistency. The axillary lymph nodes were not palpable. The left breast showed a 2 x 3 cm painless, movable nodule, with well-defined edges, and fibroelastic consistency. We performed left-breast mammography, which showed several nodules with well-defined edges, the largest being 2 x 3 cm and exhibiting rough calcification and grouped
microcalcifications within it. The patient underwent a frozen biopsy that showed a malignant variant of the
phyllodes tumor in the right breast and
fibroadenoma in the left one. After that, we performed a
total mastectomy in the right breast and an excision biopsy in the left one.
Paraffin study confirmed the frozen biopsy result from the right breast, yet we observed that in the interior of the
fibroadenoma that was removed on the left, there was a focal area of invasive
lobular carcinoma measuring 0.4 cm. The patient then underwent a modi-fied
radical mastectomy with total axillary
lymphadenectomy. None of the 21 dissected lymph nodes showed evidence of
metastasis. In the follow-up, the patient evolved asymptomatically and with normal physical and laboratory examination results up to July 1997.