{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T07:49:28Z","timestamp":1773733768858,"version":"3.50.1"},"reference-count":35,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T00:00:00Z","timestamp":1773705600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Phyllodes Tumor (PT) is a rare fibroepithelial tumor, which is classified into three categories: benign, borderline, and malignant. The three types show a gradually increasing trend in terms of local recurrence and distant metastasis. Giant PT usually refers to a mass with a diameter larger than 10\u00a0cm, accounting for approximately 20% of PT cases. Borderline PT (BPT) has overlapping clinical manifestations with both benign fibroadenomas and malignant breast tumors. Especially when it presents with rapid growth and ulceration, it is easily misdiagnosed as advanced breast cancer.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>This paper reports a case of a 44-year-old female patient who was admitted to the hospital with the chief complaint of \u201cdiscovering a painless mass in the left breast several months ago and presenting due to rapid enlargement accompanied by skin ulceration in the past month\u201d. Physical examination revealed a huge mass (approximately 24\u00d717\u00d715 cm) in the left breast, with diffuse skin edema, redness, increased skin temperature, and multiple skin ulcers.A small nodule can be palpated in the right breast. Preoperative auxiliary examinations: Breast ultrasound indicated a nodule in the right breast (BI-RADS category 4a) and disordered glandular structure in the left breast (BI-RADS category 0) accompanied by axillary lymph node enlargement; PET-CT showed significantly increased metabolism in the left breast mass (SUVmax 11.5) and ipsilateral axillary lymph nodes (SUVmax 9.0), highly suggestive of malignancy with axillary lymph node metastasis. Core needle biopsy (CNB) of the left breast mass suggested a fibroepithelial tumor, favoring PT, but the grade could not be determined. After discussion by the multidisciplinary team (MDT), the patient underwent total mastectomy of the left breast + axillary lymph node dissection(ALND) of the left side + resection of the right breast mass. Postoperative paraffin pathology and extensive immunohistochemistry confirmed BPT of the left breast (mitotic figures approximately 7\/10 HPF, negative surgical margins), and all 21 dissected lymph nodes on the ipsilateral side showed reactive hyperplasia; the nodule in the right breast was a FA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This case highlights the diagnostic dilemma of giant BPT, which clinically and radiologically mimics locally advanced or metastatic breast cancer. Preoperative CNB has limitations in PT grading, and the final diagnosis depends on histopathological examination of completely resected specimens. For tumors with necrosis, ulceration, and infection, the high metabolic findings on PET-CT should be interpreted with caution, as they may be caused by secondary inflammatory responses rather than specifically indicating highly invasive cancer or metastasis, thus avoiding overstaging and overtreatment before surgery. The core of treatment is wide surgical resection with negative margins, and a prudent approach should be taken towards axillary management, with routine axillary dissection not recommended. The multidisciplinary collaborative model is crucial for integrating conflicting information and achieving individualized and precise decision-making. In the future, it is necessary to explore a dynamic risk assessment system integrating clinical, pathological, and molecular features to improve the individualized management level of PT.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fonc.2026.1793170","type":"journal-article","created":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T05:25:05Z","timestamp":1773725105000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Case Report: Coexistence of a giant borderline phyllodes tumor of the breast and a contralateral fibroadenoma: a challenging case with clinical manifestations and PET-CT imaging mimicking advanced cancer"],"prefix":"10.3389","volume":"16","author":[{"given":"Xin-Ru","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Breast and Thyroid Surgery, the Affiliated Hospital of Yanbian University (Yanbian Hospital)","place":["Yanji, Jilin, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qiang","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Medical Imaging and Nuclear Medicine, the Affiliated Hospital of Yanbian University (Yanbian Hospital)","place":["Yanji, Jilin, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xing-Guo","family":"Cui","sequence":"additional","affiliation":[{"name":"Department of Breast and Thyroid Surgery, the Affiliated Hospital of Yanbian University (Yanbian Hospital)","place":["Yanji, Jilin, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,3,17]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.32074\/1591-951X-754","article-title":"Malignant phyllodes tumor of the breast: a systematic review","volume":"114","author":"Lissidini","year":"2022","journal-title":"Pathologica"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1186\/1477-7819-6-117","article-title":"Giant breast tumors: surgical management of phyllodes tumors, potential for reconstructive surgery and a review of literature","volume":"6","author":"Liang","year":"2008","journal-title":"World J Surg Oncol"},{"key":"B3","doi-asserted-by":"crossref","unstructured":"A multidisciplinary perspective on breast phyllodes tumors: a literature review\n          \n          \n            \n              Naum\n              AG\n            \n            \n              Ursu\n              AM\n            \n            \n              Moisii\n              P\n            \n            \n              Lupascu-Ursulescu\n              C-V\n            \n            \n              Gheorghe\n              L\n            \n            \n              Jari\n              I\n            \n          \n          Medicina\n          61\n          2025","DOI":"10.3390\/medicina61101883"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1038\/ng.3409","article-title":"Genomic landscapes of breast fibroepithelial tumors","volume":"47","author":"Tan","year":"2015","journal-title":"Nat Genet"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1016\/j.pathol.2023.02.001","article-title":"Refining the classification of breast phyllodes tumours","volume":"55","author":"Tan","year":"2023","journal-title":"Pathology"},{"key":"B6","doi-asserted-by":"publisher","first-page":"12046","DOI":"10.1038\/s41598-021-91404-y","article-title":"Relationship of the standard uptake value of 18F-FDG-PET-CT with tumor-infiltrating lymphocytes in breast tumors measuring \u2265 1 cm","volume":"11","author":"Park","year":"2021","journal-title":"Sci Rep"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-023-10208-y","article-title":"Value of [18F]AlF-NOTA-FAPI-04 PET\/CT for differential diagnosis of Malignant and various inflammatory lung lesions: comparison with [18F]FDG PET\/CT","volume":"34","author":"Qiao","year":"2024","journal-title":"Eur Radio"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.3233\/BD-210025","article-title":"An integrative ultrasound-pathology approach to improve preoperative phyllodes tumor classification: a pilot study","volume":"41","author":"Locicero","year":"2022","journal-title":"Breast Dis"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1136\/esmoopen-2020-000843","article-title":"Prognostic factors in phyllodes tumours of the breast: retrospective study on 166 consecutive cases","volume":"5","author":"Di Liso","year":"2020","journal-title":"ESMO Open"},{"key":"B10","doi-asserted-by":"publisher","first-page":"85","DOI":"10.1016\/j.breast.2018.11.009","article-title":"Phyllodes tumors of the breast. The treatment results for 340 patients from a single cancer centre","volume":"43","author":"Mitus","year":"2019","journal-title":"Breast"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-019-07445-1","article-title":"Predicting outcome in mammary phyllodes tumors: relevance of clinicopathological features","volume":"26","author":"Li","year":"2019","journal-title":"Ann Surg Oncol"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1016\/j.radcr.2022.07.037","article-title":"Malignant phyllodes tumor of the breast with metastases to the lungs: a case report and literature review","volume":"17","author":"Ostapenko","year":"2022","journal-title":"Radiol Case Rep"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.61770\/NBEJMS.2025.v03.i02.011","article-title":"From benign beginning to Malignant giant: the journey of recurrent cystosarcoma phyllodes","volume":"3","author":"Kumar","year":"2025","journal-title":"Natl Board Examinations J Med Sci"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1016\/j.biopha.2019.109168","article-title":"The impact of infection and inflammation in oncologic 18F-FDG PET\/CT imaging","volume":"117","author":"Rahman","year":"2019","journal-title":"Biomedicine Pharmacotherapy = Biomedecine Pharmacotherapie"},{"key":"B15","doi-asserted-by":"crossref","DOI":"10.1007\/978-3-030-81261-4_7","article-title":"2-[18F]FDG PET imaging of infection and inflammation","volume-title":"Nuclear Medicine and Immunology","author":"Minamimoto","year":"2022"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1007\/s12149-020-01517-z","article-title":"Assessment of SPECT-CT fusion images and semi-quantitative evaluation using SUV in 123I-IMP SPECT in patients with choroidal melanoma","volume":"34","author":"Yamazaki","year":"2020","journal-title":"Ann Nucl Med"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1007\/s12149-024-01903-x","article-title":"Properties of [18F]FAPI monitoring of acute radiation pneumonia versus [18F]FDG in mouse models","volume":"38","author":"Liu","year":"2024","journal-title":"Ann Nucl Med"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.21037\/jtd.2016.10.109","article-title":"Diagnostic performance of core needle biopsy in identifying breast phyllodes tumors","volume":"8","author":"Zhou","year":"2016","journal-title":"J Thorac Dis"},{"key":"B19","doi-asserted-by":"publisher","first-page":"86","DOI":"10.1200\/jco.2014.32.26_suppl.86","article-title":"Predicting the biologic classification of phyllodes tumors from preoperative core needle biopsy and imaging findings","volume":"32","author":"Yasir","year":"2014","journal-title":"J Clin Oncol"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1177\/0846537119899553","article-title":"Phyllodes tumors-the predictors and detection of recurrence","volume":"72","author":"Lim","year":"2021","journal-title":"Can Assoc Radiologists J = J l\u2019Association Can Des Radiologistes"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1111\/ans.18264","article-title":"Surgery for phyllodes tumour of the breast. What should be surgical margins","volume":"93","author":"Tukenmez","year":"2023","journal-title":"Anz J Surg"},{"key":"B22","unstructured":"Radical mastectomy SANS axillary lymph node dissection for large phyllodes tumor: a guarantee against recurrence | Indian Journal of Surgery\n          \n          10.1007\/s12262-018-1852-y\n          41816700"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1093\/jscr\/rjab302","article-title":"Malignant phyllodes tumor with synchronous metastases to axillary lymph nodes, lung at the presentation: a case report and literature review","volume":"2021","author":"Le","year":"2021","journal-title":"J Surg Case Rep"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijscr.2019.12.026","article-title":"Gaint phyllodes tumour with axillary & interpectoral lymph node metastasis; a rare presentation","volume":"66","author":"Shafi","year":"2019","journal-title":"Int J Surg Case Rep"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1177\/10668969221125791","article-title":"Lymph node and distant metastases in phyllodes tumor of the breast","volume":"31","author":"Naal","year":"2023","journal-title":"Int J Surg Pathol"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1038\/ng.3037","article-title":"Exome sequencing identifies highly recurrent MED12 somatic mutations in breast fibroadenoma","volume":"46","author":"Lim","year":"2014","journal-title":"Nat Genet"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1038\/bjc.2015.116","article-title":"Frequent MED12 mutations in phyllodes tumours of the breast","volume":"112","author":"Yoshida","year":"2015","journal-title":"Br J Cancer"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1016\/j.tranon.2024.101998","article-title":"Integrated multi-omics profiling reveals a clinically relevant molecular feature and potential therapeutic target on phyllodes tumors of breast","volume":"46","author":"Xu","year":"2024","journal-title":"Transl Oncol"},{"key":"B29","doi-asserted-by":"publisher","first-page":"40","DOI":"10.1038\/s41523-017-0042-6","article-title":"Phyllodes tumors with and without fibroadenoma-like areas display distinct genomic features and may evolve through distinct pathways","volume":"3","author":"Pareja","year":"2017","journal-title":"NPJ Breast Cancer"},{"key":"B30","doi-asserted-by":"publisher","first-page":"398","DOI":"10.32768\/abc.202293398-400","article-title":"Benign and borderline phyllodes: management and follow-up: phyllodes management","volume":"9","author":"Sharma","year":"2022","journal-title":"Arch Breast Cancer"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.1016\/j.tranon.2024.101998","article-title":"Integrated multi-omics profiling reveals a clinically relevant molecular feature and potential therapeutic target on phyllodes tumors of breast","volume":"46","author":"Xu","year":"2024","journal-title":"Transl Oncol"},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.1158\/1078-0432.CCR-23-1184","article-title":"Novel genomic risk stratification model for primary gastrointestinal stromal tumors (GIST) in the adjuvant therapy era","volume":"29","author":"Dermawan","year":"2023","journal-title":"Clin Cancer Research: Off J Am Assoc For Cancer Res"},{"key":"B33","doi-asserted-by":"publisher","first-page":"120","DOI":"10.1097\/eus.0000000000000119","article-title":"Enhancing gastrointestinal stromal tumor risk stratification: a novel deep learning approach applied to EUS imaging","volume":"14","author":"Qu","year":"2025","journal-title":"Endosc Ultrasound"},{"key":"B34","doi-asserted-by":"publisher","DOI":"10.1007\/s11547-023-01637-2","article-title":"Prediction of the mitotic index and preoperative risk stratification of gastrointestinal stromal tumors with CT radiomic features","volume":"128","author":"Lin","year":"2023","journal-title":"La Radiologia Med"},{"key":"B35","doi-asserted-by":"publisher","DOI":"10.4103\/njcp.njcp_1374_21","article-title":"Factors effective on recurrence and metastasis in phyllodes tumors","volume":"25","author":"Altiok","year":"2022","journal-title":"Nigerian J Clin Pract"}],"container-title":["Frontiers in Oncology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2026.1793170\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T05:25:20Z","timestamp":1773725120000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2026.1793170\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,17]]},"references-count":35,"alternative-id":["10.3389\/fonc.2026.1793170"],"URL":"https:\/\/doi.org\/10.3389\/fonc.2026.1793170","relation":{},"ISSN":["2234-943X"],"issn-type":[{"value":"2234-943X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,17]]},"article-number":"1793170"}}