# Malignant Phyllodes Tumor With Left Atrial and Bilateral Pulmonary Metastases Treated Surgically: A Case Report

## TL;DR

A rare case of a malignant phyllodes tumor spreading to the heart and lungs was treated surgically, but the disease progressed despite treatment.

## Contribution

This case report highlights the rare occurrence of intracardiac metastasis from a malignant phyllodes tumor and the potential role of surgical intervention.

## Key findings

- Surgical resection of left atrial tumor and lung metastases was performed due to high risk of cardiac complications.
- Histopathology confirmed metastatic malignant phyllodes tumor in all resected specimens.
- Despite surgery and chemotherapy, the disease progressed and the patient passed away within six months.

## Abstract

We report a rare case of a malignant phyllodes tumor with left atrial and bilateral pulmonary metastases. A woman in her 40s had undergone a tumorectomy for a benign phyllodes tumor of the right breast. Two years later, she developed local recurrence diagnosed as a malignant phyllodes tumor and underwent total mastectomy. At follow-up two years after surgery, computed tomography (CT) revealed bilateral pulmonary metastases with tumor extension into the pulmonary veins and left atrium. Echocardiography showed a mobile left atrial mass. Due to the risk of cardiac complications, surgical resection was performed. The patient underwent left atrial tumor resection, right lower lobectomy, and left upper lobe partial resection. Histopathological findings confirmed metastatic malignant phyllodes tumor in all specimens. Postoperatively, she received five cycles of doxorubicin, but the disease progressed, and she passed away six months after surgery. Intracardiac metastasis from a malignant phyllodes tumor is extremely rare and often fatal. Prompt surgical intervention may be beneficial in select cases. In the future, with the development of effective drug therapy for malignant phyllodes tumors, long-term survival may be expected with multidisciplinary treatment, including surgery, even in cases of distant metastasis.