MRI Case 23

25 y/o F with p53 mutation presents for diagnostic MRI to determine extent of disease. What is the most likely diagnosis?

Phyllodes Tumor

  • MRI features: circumscribed margins, round/oval shape, heterogeneous internal enhancement (similar to fibroadenomas)
  • Nonenhancing internal septations are seen in ~50% of cases
  • Can see increased T2 signal intensity
  • Kinetics are classically suspicious (washout)
  • NOTE: This patient also has linear enhancement on the left which was biopsied and confirmed to be DCIS

Related Radiology Article: Wurdinger S, Herzog AB, Fischer DR, Marx C, Raabe G, Schneider A, Kaiser WA. Differentiation of phyllodes breast tumors from fibroadenomas on MRI. American Journal of Roentgenology. 2005 Nov;185(5):1317-21.