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Special Feature
December 1, 2006

Image of the Month—Quiz Case

Author Affiliations


Arch Surg. 2006;141(12):1263. doi:10.1001/archsurg.141.12.1263

A 61-year-old Filipino woman had a recent episode of syncope and unintentional weight loss noted over a 6-month period. On physical examination, she was found to be tachycardic and to have a large necrotic mass in her right breast (Figure 1). Laboratory findings were notable for anemia with a hematocrit value of 19%. A fine-needle aspiration biopsy of the mass showed only cellular stromal fragments with no cytological atypia. Chest computed tomography showed a 21 × 18-cm, smooth-contoured, heterogeneous chest wall mass with no obvious chest wall invasion (Figure 2).

Figure 1. 
Necrotic breast mass.

Necrotic breast mass.

Figure 2. 
Computed tomographic scan of the chest.

Computed tomographic scan of the chest.

What Is the Diagnosis?

A. Invasive ductal carcinoma of the breast

B. Phyllodes tumor

C. Leiomyosarcoma

D. Rhabdomyosarcoma