We report a rare case that after rapid recurrence there was pathological transition from a fibroadenoma and benign phyllodes tumor to borderline and malignant phyllodes tumor. Another rare finding included tumor dissemination in the pleural cavity via reconstructed deep inferior epigastric perforator flap edge and internal mammary vessel bundle. Hence, we eliminated the use of internal mammary vessel bundle as the recipient vessel for free-flap reconstruction to avoid recurrence in the pleural cavity. Remarkably, we achieved successful reconstruction of 2 huge defects (reconstruction of breast following mastectomy and that of chest wall following en bloc excision of recurrence) using 2 different free flaps.
From the *Division of Plastic and Reconstruction Surgery, Department of Surgery, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi;
†Department of Food Nutrition and Health Biotechnology, College of Medical and Health Science, Asia University, Taichung; and
‡Division of General Surgery, Department of Surgery, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi, Taiwan.
Received May 5, 2018, and accepted for publication, after revision November 7, 2018.
Conflicts of interest and sources of funding: none declared.
Reprints: Chien-Liang Fang, MD, MBA, Ditmanson Medical Foundation Chia-Yi Christian Hospital, #539, Jhongsiao Rd, Chia-Yi City, 60002, Taiwan. E-mail: firstname.lastname@example.org.