Wide local excision for small tumors and simple mastectomy for larger ones are usually satisfactory. Excision of the pectoralis major muscle may be necessary, if the fascia or muscle is infiltrated. Because of very low incidence of lymph node involvement, most of the studies believe that axillary node clearance is not required.2,11,12 Conclusion The signs and symptoms

as well as laboratory and radiographic findings of the present case indicate that it was a case of malignant phylloides tumor of breast. Such a tumor can occur in pregnancy Inhibitors,research,lifescience,medical and is fast growing. Conflict of Interest: None declared
An 18-year-old female student referred to JSS Hospital, city of Mysore, state of Karnataka, South India with chief complaints of cough with white mucoid sputum since two months, swelling over the back on the left side since one and a half months, and weight loss since one month. There was no history of fever, breathlessness, chest pain or Inhibitors,research,lifescience,medical hemoptysis and no history of contact with a case of tuberculosis. On examination, the patient was moderately built and nourished with weight of 46 kg, height of 153 cm and body mass index (BMI) of 19.5, pulse rate of 110/min, blood pressure Inhibitors,research,lifescience,medical of 110/80 mmHg. She had right posterior cervical lymphadenopathy with a node, which was single, non tender, mobile,

firm in consistency, and measuring 3×2 cm. Local examination revealed a swelling in the left side of the chest on the posterior aspect Inhibitors,research,lifescience,medical in infrascapular region (figure 1). The swelling, measuring about 10×10 cm in size, was non tender,

soft in Duvelisib mouse consistency with no local rise of temperature. The swelling was also fluctuant and irreducible, had no cough impulse, and was situated Inhibitors,research,lifescience,medical in the subcutaneous plane. Respiratory system examination revealed dullness in the left infra-axillary area with reduced intensity of breath sounds. The examination of other systems revealed nothing remarkable. Figure 1 A swelling in left infrascapular region The patient’s hemoglobin was 9.5 gm%, and the smear of her peripheral blood showed normocytic normochromic anemia. Her erythrocyte sedimentation rate was 110 mm. at the end of first hour. Complete blood cell and platelet counts were within normal limits. The random blood sugar was 86 mg/dl. Liver function and renal function tests were within normal limits. Plain chest radiograph showed non-homogenous and opacity in the left lower zone with blunting of left costo-phrenic angle (figure 2). It also showed asymmetry of the soft tissue shadow on the left side of the chest with mediastinal lymphadenopathy. Figure 2 Initial Chest X-Ray showing non-homogenous opacity in the left lower zone with blunting of left costo-phrenic angle. Computed tomography (CT) of the thorax showed features suggestive of pulmonary tuberculosis in the left lower lobe (figures 3 and ​and4).4).