Recurrent Fibroadenoma and Concomitant Mucinous Cancer with Ductal Carcinoma In situ Following Benign Phyllodes Tumor Excision - A Rare Case Report

Sep 28, 2026

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A 37-year-old woman was diagnosed in 2022 with fibroadenoma (FA) accompanied by extensive spreading ductal carcinoma in situ (DCIS) and multifocal mucinous carcinomas. She had previously been diagnosed with FA and underwent excision in 2016 after presenting with a palpable left breast mass. Periodic ultrasound in 2020 detected a new tumor in the same region, and core biopsy showed a fibroepithelial lesion. Wide excision revealed a benign phyllodes tumor with a clear margin. This case highlights the need for continuous follow-up after complete resection of FA, given possible recurrence with other fibroepithelial tumors and subsequent malignant transformation.

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CategoryHealthcare

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Abstract

Introduction

Case report

Discussion

| Case Report | | --- | | | Recurrent Fibroadenoma and Concomitant Mucinous Cancer with Ductal Carcinoma In situ Following Benign Phyllodes Tumor Excision: A Rare Case Report Pei‑Shyuan Lee1, Ming‑Lin Tsai2, Yu‑Chi Chang1, Shing‑Huey Lin1* 1Department of Family and Community Medicine, Cathay General Hospital, Taipei, Taiwan, 2Department of Breast Surgery, Cathay General Hospital, Taipei, Taiwan Abstract A 37‑year‑old woman was diagnosed with a fibroadenoma (FA) with concomitant extensive spreading of ductal carcinoma in situ (DCIS) and multifocal mucinous carcinomas in 2022. Previously, she was first diagnosed with a FA and received excision in 2016. The initial clinical presentation was a palpable mass in the left breast. During periodic breast ultrasound examination in 2020, another newly developed tumor was found in the same region. A core biopsy revealed a fibroepithelial lesion. The patient received wide excision surgery. The final pathology report indicated a phyllodes tumor (PT) with a clear margin. All three events occurred in the same region (left breast, at 2 O’clock and 3–5 cm from the nipple). Our patient had a relapsed FA, which progressed into a benign PT and FA concomitant with DCIS and multifocal mucinous carcinomas. We report this case to highlight the need for continuous follow‑up for FA cases even after complete resection and the possibility of recurrence with other fibroepithelial tumors. Keywords: Benign phyllodes tumor, breast cancer, case report, ductal carcinoma in situ, recurrent fibroadenoma IntroductIon Fibroepithelial lesions (FELs) are categorized into fibroadenomas (FAs) and phyllodes tumors (PTs), the latter accounting for 0.3%–1% ofFELs and usually requiring surgical excision. FAs are usually managed by regular follow‑up. An increased risk of breast cancer subsequent to a diagnosis of an FA has been reported,[1] and a special surveillance regimen should be adopted for women with breast cancer risk. The incidence of carcinomas within FAs is estimated at 0 . 1%–0 .3%, and FAs could be a long‑term risk factor for invasive breast cancer.[2,3] Distinguishing benign PTs from FAs is difficult in the early stage due to overlapping radiology and microscopic features. Herein, we present a case of recurrent FAs in a patient who underwent two tumor excisions and still developed PTs with recurrent FAsand mucinous cancer with ductal carcinoma in situ (DCIS) . case report We present the case of a 31‑year‑old woman who presented to the breast surgeon outpatient department with a palpable Received: 24‑07‑2024 Revised: 27‑11‑2024 Accepted: 02‑12‑2024 Available Online: 11‑06‑2025 | Access this article online | | | --- | --- | | Quick Response Code:
| Website:
[https://journals.lww.com/jmut](https://journals.lww.com/jmut) | | | DOI:
10.4103/jmu.jmu_93_24 | mass lesion in the left breast in 2016. There was no known family history of breast cancer or other gynecological cancer. Her ultrasound showed a 2 cm, partially ill‑defined hypoechoic breast nodule over the left breast at 2 O’clock and 4 cm from the nipple (left 2/4) [Figure 1] . The patient underwent tumor excision and the pathology report indicateda FA. In 2020, during a periodic breast ultrasound follow‑up, a newly developed, partially ill‑defined hypoechoic nodule was detected at left 2/5 [Figure 2]. The result of a core biopsy indicated a FEL. Further wide excision surgery was performed and the final pathology indicated a benign PT with a clear margin (1 cm from the tumor and free of cancer) . During regular breast imaging follow‑up in August 2022, a new 1.0 cm hypoechoic nodule was found at left 2/5 [Figure 3] . In January 2023, rapid interval growth was noticed in breast sonography [Figure 4] . The size of the left 2/5 hypoechoic Address for correspondence: Dr. Shing‑Huey Lin, Department of Breast Surgery, Cathay General Hospital, No. 280, Ren‑Ai Road, Sec. 4, Taipei, Taiwan. E‑mail: [cgh07452@cgh.org.tw](cgh07452@

FAQs

How were the recurrent lesions evaluated and treated?

Recurrent lesions were evaluated using periodic breast ultrasound and core needle biopsy results indicating fibroepithelial lesions. Treatment included wide excision surgery, followed by partial mastectomy and sentinel lymph node biopsy when malignant components were identified.

Sep 28, 2026

Uploaded by hdkawk