case_images: PMC11809272_01
case_images: Magnetic resonance imaging of the breast (T2-weighted scan) in axial (A) and sagittal (B) plane showing a lesion occupying almost the entire right breast, with well-defined lobulated contours, measuring 93x71x82 mm and contact with the pectoral muscle and the skin surface (white arrows).. F: foot direction; H: head direction; L: left direction; R: right direction
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case_images: FIG1
case_images: A magnetic resonance imaging (MRI) of the breast was performed and showed a lesion occupying almost the entire right breast, with well-defined lobulated contours, measuring 93x71x82 mm, showing a high signal on T2-weighted images, and contacting the pectoral muscle and the skin surface (Figure 1).
case_images: Computer tomography scan of the thorax showing showing in the apical segment of the right upper lobe, a nodule measuring 34 mm (black circle), adjacent to the anterior pleura with a slight retraction.
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case_images: PMC11809272_01_cureus-0017-00000077277-i02.jpg
case_images: FIG2
case_images: A fluorodeoxyglucose (FDG)-positron emission tomography (PET) scan showing a moderate uptake of 18F-FDG (SUVmax = 3.15) in a large formation in the outer quadrants of the right breast (white arrows), and a moderate uptake of 18F-FDG (SUVmax = 2.35) in a pulmonary lesion of the right upper lobe (white circle).
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case_images: PMC11809272_01_cureus-0017-00000077277-i03.jpg
case_images: FIG3
case_images: Breast mammography. Breasts with a moderately dense pattern. A large, high-density mass with lobulated contours, measuring approximately 8.2 cm, is identified in the upper outer quadrant/transition of the outer quadrants of the right breast, with coarse calcifications at the periphery, corresponding to the previously known neoformative lesion. In the left breast, a medium-density nodule with slightly lobulated margins is seen in the transition of the upper quadrants (circle), which corresponds to a cyst on ultrasound.
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case_images: PMC11809272_01_cureus-0017-00000077277-i04.jpg
case_images: FIG4
case_images: A new mammography was performed, revealing a reduction in the size of the lesion (Figure 4).
case_images: Low magnification of the core biopsy showing a fibroepithelial lesion with expansion of the stroma and low cellularity.
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case_images: FIG5
case_images: A new core biopsy was performed, and histological and immunohistochemical examination revealed a fibroepithelial lesion with benign characteristics, favoring the diagnosis of a benign phyllodes tumor (Figure 5).
case_images: Immunoreactivity for estrogen receptors in the epithelial component detected in the core biopsy.
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case_images: PMC11809272_01_cureus-0017-00000077277-i06.jpg
case_images: FIG6
case_images: Due to the favorable response to anastrozole, immunohistochemical analysis of endocrine receptors was performed, revealing 90-100% positivity for estrogen receptors in the epithelial component (Figure 6), without expression of progesterone receptors and human epidermal growth factor receptor 2 (HER2).
case_images: Histologic section showing fronds of homogeneous stroma with low cellularity covered by a thin layer of epithelium, compatible with a phyllodes tumor.
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case_images: FIG7
case_images: The operative specimen revealed a tumor measuring 76x44x46 mm, consistent with a benign phyllodes tumor and without signs of malignancy (Figure 7); there was no evidence of margin involvement (R0 surgery).
case_images: High magnification of a histologic section of the colloid adenocarcinoma of lung showing cuboidal tumor cells with hyperchromatic nuclei lining a mucin pool. Tumor cells markedly distend airspaces and destroy alveolar walls.
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case_images: PMC11809272_01_cureus-0017-00000077277-i08.jpg
case_images: FIG8
case_images: After this surgery, the patient underwent a right upper lobectomy, which revealed a colloid adenocarcinoma of the lung (Figure 8).