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Giant phyllodes tumors are rare fibroepithelial neoplasms, usually defined as >10 cm. It is often difficult for pathologists to distinguish fibroadenomas from phyllodes tumors and determine the malignant potential level. The current treatment principle is to ensure the extended resection of tumors with a margin of 1 cm or more. For patients with multiple local recurrences or large tumors after surgery, simple mastectomy is recommended. Axillary management should be considered when breast cancer is diagnosed at the same time. We now present a rare case: a female patient found a right breast mass in 2014, and the mass had continued to grow for more than 7 months, and she was ultimately diagnosed with a giant phyllodes tumor with a diameter of 30 cm. Extensive resection is a suitable method to treat smaller phyllodes tumors, but giant phyllodes tumors require mastectomy, so the patient in this case underwent a total mastectomy. We removed the mass completely without destroying the normal tissue and structure. The treatment effect was obvious, and no related adverse events occurred during or after the operation, the postoperative recovery was good, and the patient was discharged once she was verified to be in a stable condition. This case is the first reported case of a patient who had a giant borderline phyllodes tumor with a diameter of 30 cm, underwent total mastectomy, and was followed up for 6 months without recurrence. The long-term effect of the treatment will be further evaluated after 5 years.

Background:To determine the efficacy and safety of perineal nerve block (PNB) and modified perineal nerve block (PNB-1) in ultrasound-guided transperineal prostate biopsy(TPBx). Methods:910 patients were enrolled from March 2019 to December 2021. They were divided into two groups based on their anesthesia methods: PNB group (375 patients) and PNB-1 group (535 patients). The pain scores were evaluated using visual analogue scale (VAS) at the start of anesthesia, during puncture biopsy, and one hour after operation.The chi-square test was used for comparison.Result:At the start of anesthesia, there was no significant difference in pain scores between the PNB and PNB-1 groups (P>0.05), but there was a significant difference in pain scores between the two groups at the time of puncture (PPP>0.05). Postoperative complications in the PNB-1 group were significantly less than those in the PNB group, and the postoperative urinary tract irritation sign was significantly less than that in the PNB group (PConclusion:PNB-1 was a effective and safe anesthesia method, which could significantly reduce the pain during puncture biopsy, improve the anesthetic effect and provide the basis for puncture biopsy.