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An elderly lady presented to the surgical outpatient with a lump in her breast. On examination, there was a well-defined large lump measuring about 12 × 10 cm, hard in consistency and fixed to the chest wall, the skin appeared to be free, and the nipple-areola complex was normal. A provisional diagnosis of phylloides tumor was made, but digital rectal examination revealed a circumferential rectal growth. To our surprise, biopsy of the rectal growth and the chest wall mass revealed similar adenocarcinoma cells. This image illustrates the possibility that a common clinical entity such as a breast lump can sometimes surprise even the most seasoned clinicians.

Breast Lumps That Do Not Arise from the Breast