CTICasesMalignant Phyllodes Tumor of the Breast with Invasion of All Four Pulmonary Veins
Imaging findings
In a patient with known breast cancer, imaging showed extensive right axillary and right lung tumor with direct tumor growth into all four pulmonary veins, both superior and inferior bilaterally, extending into the left atrium, accompanied by pleural involvement. Associated right upper lobe opacity was thought to reflect hemorrhage or hemorrhagic infarction from venous ischemia.
Key takeaways
Immunohistochemistry favored a phyllodes tumor over a metaplastic adenocarcinoma as the breast primary. This represents an extremely aggressive tumor with a striking, unusual pattern of direct intravascular growth into the pulmonary veins and left atrium, and the patient died shortly after imaging despite prior therapy.
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