case_images: PMC9623357_01
case_images: (A) The malignant phyllodes tumor of breast showed stromal overgrowth (arrow;
  H&E, 100x). (B) The stroma of the phyllodes tumor showed atypia and
  frequent mitotic figures (arrow; H&E, 400x).
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case_images: Microscopically, the tumor nodules showed fibroepithelial neoplasm with features including areas of stromal overgrowth (Figure 1A). The stroma showed hypercellularity with nuclear atypia and increased mitotic activity (up to 10-14 mitoses per 10 high-power fields were counted in areas of stromal overgrowth; Figure 1B).
case_images: Computed tomography scan of the thorax with contrast showing large left-sided
  pleural effusion and multiple soft tissue masses in bilateral lung lobes
  (red arrows).
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case_images: Ten months later, the patient presented for dyspnea and was found to have a large left-sided pleural effusion and multiple soft tissue masses in bilateral lung lobes (Figure 2).
case_images: (A) The pleural biopsy showed metastatic phyllodes tumor characterized by
  sheets of spindle cells (H&E, 100x). (B) The spindle cells showed
  significant nuclear atypia (H&E, 400x).
case_images: 10.1177_23247096221133197-fig3.jpg
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case_images: Microscopically, sections showed sheets of malignant spindle cells with features including hypercellular stroma with nuclear atypia, similar to the primary malignant phyllodes tumor (Figure 3A and 3B).
case_images: T2 MRI brain showing 5 mm enhancing lesion in the right parietal lobe (red
  arrow).. Abbreviation: MRI, magnetic resonance imaging.
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case_images: The magnetic resonance imaging (MRI) of the brain was significant for a 5 mm T2 hyperintense enhancing lesion in the right parietal lobe (Figure 4), also concerning for metastatic disease.