case_images: PMC6880032_01
case_images: Pathology: Neoplastic stroma.. H&E stained image demonstrates benign breast epithelium with apocrine
  metaplasia. The surrounding stroma represents the neoplastic stroma of the
  phyllodes tumor.
case_images: 10.1177_2036361319890710-fig1.jpg
case_images: PMC6880032_01_10.1177_2036361319890710-fig1.jpg
case_images: fig1-2036361319890710
case_images: Phyllodes tumors which exhibit a percanalicular and infiltrative pattern are also called periductal stromal sarcomas, thus placing our tumor in this category (Figures 1-7).
case_images: Pathology: Benign breast epithelium.. H&E stained image demonstrates benign breast epithelium with apocrine
  metaplasia and usual ductal hyperplasia. The surrounding stroma is
  neoplastic.
case_images: 10.1177_2036361319890710-fig2.jpg
case_images: PMC6880032_01_10.1177_2036361319890710-fig2.jpg
case_images: fig2-2036361319890710
case_images: Phyllodes tumors which exhibit a percanalicular and infiltrative pattern are also called periductal stromal sarcomas, thus placing our tumor in this category (Figures 1-7).
case_images: Pathology: Pericanalicular growth, 100x.. Pericanalicular growth: H&E stained image demonstrating a pericanalicular
  overgrowth of spindle-shaped stromal cells (magnification 100x).
case_images: 10.1177_2036361319890710-fig3.jpg
case_images: PMC6880032_01_10.1177_2036361319890710-fig3.jpg
case_images: fig3-2036361319890710
case_images: Phyllodes tumors which exhibit a percanalicular and infiltrative pattern are also called periductal stromal sarcomas, thus placing our tumor in this category (Figures 1-7).
case_images: Pathology: Phyllodes mitoses, 400x.. Phyllodes mitoses: H&E stained image exhibits three mitotic figures and
  overgrowth of spindle-shaped stromal cells. Mitotic count was 32 per 10 high
  power fields in the most proliferative area. (magnification 400x).
case_images: 10.1177_2036361319890710-fig4.jpg
case_images: PMC6880032_01_10.1177_2036361319890710-fig4.jpg
case_images: fig4-2036361319890710
case_images: Phyllodes tumors which exhibit a percanalicular and infiltrative pattern are also called periductal stromal sarcomas, thus placing our tumor in this category (Figures 1-7).
case_images: Pathology: Pericanalicular growth.. Pericanalicular pattern of stromal overgrowth with retained benign breast
  epithelial component.
case_images: 10.1177_2036361319890710-fig5.jpg
case_images: PMC6880032_01_10.1177_2036361319890710-fig5.jpg
case_images: fig5-2036361319890710
case_images: Phyllodes tumors which exhibit a percanalicular and infiltrative pattern are also called periductal stromal sarcomas, thus placing our tumor in this category (Figures 1-7).
case_images: Pathology: Pericanalicular growth.. Pericanalicular pattern of stromal overgrowth with retained benign breast
  epithelial component.
case_images: 10.1177_2036361319890710-fig6.jpg
case_images: PMC6880032_01_10.1177_2036361319890710-fig6.jpg
case_images: fig6-2036361319890710
case_images: Phyllodes tumors which exhibit a percanalicular and infiltrative pattern are also called periductal stromal sarcomas, thus placing our tumor in this category (Figures 1-7).
case_images: Pathology: Malignant osteoid.. Malignant osteoid: H&E stained image shows spindle cells, scattered giant
  cells, and malignant osteoid representing the heterologous element of
  osteosarcoma in the setting of a malignant phyllodes tumor.
case_images: 10.1177_2036361319890710-fig7.jpg
case_images: PMC6880032_01_10.1177_2036361319890710-fig7.jpg
case_images: fig7-2036361319890710
case_images: Phyllodes tumors which exhibit a percanalicular and infiltrative pattern are also called periductal stromal sarcomas, thus placing our tumor in this category (Figures 1-7).
case_images: Pathology: IHC stain, EMA.. Immunohistochemistry stain for epithelial membrane antigen, negative.
case_images: 10.1177_2036361319890710-fig8.jpg
case_images: PMC6880032_01_10.1177_2036361319890710-fig8.jpg
case_images: fig8-2036361319890710
case_images: Multiple immunostains were negative including pancytokeratin (CK AE1/AE3), CK5/6, and EMA, thus eliminating metaplastic carcinoma (Figures 8 and 9).
case_images: Pathology: IHC stain, pancytokeratin.. Immunohistochemistry stain for pancytokeratin, negative.
case_images: 10.1177_2036361319890710-fig9.jpg
case_images: PMC6880032_01_10.1177_2036361319890710-fig9.jpg
case_images: fig9-2036361319890710
case_images: Multiple immunostains were negative including pancytokeratin (CK AE1/AE3), CK5/6, and EMA, thus eliminating metaplastic carcinoma (Figures 8 and 9).
case_images: Pathology: Skull metastases.. Skull mets: H&E stained image displays numerous atypical spindle and
  epithelioid cells with mitosis and malignant osteoid, invading the bone.
  This is consistent with metastatic osteosarcoma, to the skull.
case_images: 10.1177_2036361319890710-fig10.jpg
case_images: PMC6880032_01_10.1177_2036361319890710-fig10.jpg
case_images: fig10-2036361319890710
case_images: Neurosurgery was consulted and the mass was resected (Figure 12) with the final pathology showing phyllodes tumor with osteosarcomatous elements and clear margins consistent with her original breast diagnosis (Figure 10).
case_images: Imaging: MRI axial T1 pre-op.. Axial T1-weighted post-contrast image, from 29/4/2015, shows an avidly
  enhancing 3.6-cm right parietal calvarial mass with minimal extension into
  the adjacent extra-axial space. There are no additional enhancing
  lesions.
case_images: 10.1177_2036361319890710-fig11.jpg
case_images: PMC6880032_01_10.1177_2036361319890710-fig11.jpg
case_images: fig11-2036361319890710
case_images: MRI of the brain showed a 3.6-cm right parietal and frontal bone mass with minimal extension into the adjacent extra-axial space favoring metastases (Figure 11).
case_images: Imaging: MRI axial T1 post-op.. Axial T1-weighted post-contrast image, from 15/7/2015, shows postsurgical
  changes related to a right frontoparietal cranioplasty, without evidence of
  nodular enhancement to suggest residual or recurrent tumor.
case_images: 10.1177_2036361319890710-fig12.jpg
case_images: PMC6880032_01_10.1177_2036361319890710-fig12.jpg
case_images: fig12-2036361319890710
case_images: Neurosurgery was consulted and the mass was resected (Figure 12) with the final pathology showing phyllodes tumor with osteosarcomatous elements and clear margins consistent with her original breast diagnosis (Figure 10).