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February 1, 2008

Image of the Month—Quiz Case

Author Affiliations

Author Affiliations:Departments of General Surgery and Pathology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India.



Arch Surg. 2008;143(2):207. doi:10.1001/archsurg.2007.34-a

A woman, aged 30 years, presented with a complaint of a lump, which she had had for 1 year, in her right breast. Initially, the lump was slow growing; however, for the past 4 months, the growth had become rapid, coinciding with her pregnancy of the same duration. It developed into a painful ulceroproliferative growth. There was no history of trauma, radiation exposure, or surgery, and she denied having any family history of a similar disease. An examination revealed a massive fleshy ulceroproliferative growth of 15 × 17 cm in the para-areolar region of her right breast (Figure). It was firm, not fixed to muscle or chest wall, friable, and bled to the touch; it had everted edges. The ulcerated areas were covered with slough and produced foul-smelling discharge. The ipsilateral axilla contained a few insignificant lymph nodes. The opposite breast and axilla were healthy, and changes due to pregnancy were seen in the breasts. A wedge biopsy specimen was taken from the growth. The results of chest radiography and abdominal ultrasonography were normal. Routine hematological and biochemical test results also did not show any significant abnormality. Based on the biopsy report, the lump was excised.

A woman, aged 30 years, with an ulceroproliferative exophytic mass in her right breast.

A woman, aged 30 years, with an ulceroproliferative exophytic mass in her right breast.

What Is the Diagnosis?

A. Carcinoma of the breast

B. Phyllodes tumor

C. Squamous cell carcinoma

D. Sarcoma of the breast