Phyllodes tumors are uncommon fibroepithelial breast tumors that account for less than 1% of all breast neoplasms. Malignant variants demonstrate aggressive biological behavior with a propensity for rapid growth and local recurrence. Surgical excision with adequate margins remains the primary treatment modality. In cases requiring mastectomy, reconstruction plays a vital role in restoring chest wall integrity and improving patient quality of life. The pedicled latissimus dorsi (LD) flap remains one of the most dependable reconstructive options due to its robust vascularity and technical reliability.

We present the case of a 32-year-old female with recurrent right breast mass following a prior lumpectomy. Initial diagnostic investigations including core needle biopsy and fine needle aspiration cytology were inconclusive. An excisional biopsy subsequently confirmed malignant phyllodes tumor. The patient underwent a right modified radical mastectomy, leaving a large chest wall defect. Following confirmation of negative surgical margins, reconstruction was performed using a pedicled right latissimus dorsi musculocutaneous flap. The flap was harvested with a 35 × 10 cm skin paddle and transposed to the anterior chest wall through a subcutaneous tunnel. Postoperative recovery was uneventful with excellent flap viability observed on day three. The patient was discharged on postoperative day seven and demonstrated satisfactory healing at both donor and recipient sites at three weeks follow-up.

In conclusion, this case demonstrates the feasibility of performing complex reconstructive procedures such as pedicled latissimus dorsi flap reconstruction at a county referral hospital. Expanding reconstructive surgical capacity beyond tertiary centers is essential to improving access to comprehensive oncologic and reconstructive care in resource-limited settings.

Keywords: Malignant phyllodes tumor, breast reconstruction, latissimus dorsi flap, post-mastectomy reconstruction, surgical capacity building