Heparin-binding EGF-like growth factor in diagnosis of malignant phyllodes tumor of the breast: a case report

Phyllodes tumors (PT) of the breast are rare fibroephitelial neoplasms. Malignant phyllodes tumor (MPT) usually presents rapid growth and it is difficult to distinguish it from a pure sarcoma. We report a rare case of diagnosed MPT in which we performed immunohistochemistry (IHC) for heparin-binding EGF-like growth factor (HB-EGF) considering that HB-EGF IHC was already used in other studies as a possible target of cancer in other pathologies. A 43-year-old patient presented, at physical examination, a palpable mass on the left breast with accentuated vascularization and increased growth in the last four months. The diagnosis was made through various examination such as mammogram, breast ultrasound, color-Doppler, PET, histopathological analysis and the HB-EGF IHC. Macroscopy evidenced a trilobulated lesion, measuring 9x7x7cm, and the anatomopathologic analysis confirmed the diagnosis of MPT. A strong cytoplasmic HB-EGF immunolabeling was evident. IHC is a very specific technique often able to differentiate such tumors. In the present case report IHC has evidenced the expression of HB-EGF, suggesting further investigation in order to consider HB-EGF as a possible marker in the diagnosis of MPT.