Fibroadenoma gigante juvenil de mama: presentación de un caso clínico / Juvenile giant fibroadenoma of the breast: presentation of a clinical case

RESUMEN El fibroadenoma gigante juvenil es un tumor de mama benigno y una variante rara de los fibroadenomas. La presentación clínica suele ser una masa tumoral unilateral, de crecimiento rápido e indolora. En este artículo presentamos el caso de un fibroadenoma gigante juvenil de 12 cm de diámetro en la mama de una niña de 13 años. Se realiza estudio radiológico e histológico de la lesión siendo categorizada como un fibroadenoma gigante juvenil por lo que se realiza tumorectomía completa con remodelación mamaria posterior. A los dos meses de seguimiento, la paciente se encuentra sin signos de recidiva, con buena situación general y a la espera de cirugía de remodelación mamaria.

ABSTRACT Juvenile giant fibroadenoma is a benign breast tumor and a rare variant of fibroadenomas. The clinical presentation is usually a painless, fast growing, unilateral tumor mass. In this article we present the case of a giant juvenile fibroadenoma of 12 cm in diameter in the breast of a 13-year-old girl. A radiological and histological study of the lesion was carried out and it was categorized as a juvenile giant fibroadenoma, so a complete lumpectomy with posterior breast remodeling was performed. After two months of follow-up, the patient is without signs of recurrence, in good general condition and waiting for the breast remodeling surgery.

Adding bit of esthetics with science modification of batwing mastopexy for breast conservation in a young patient with giant fibroadenoma breast

A 19-year-old girl presented with a lump in her right breast and with a history of surgery for the similar complaint 3 years back. Ultrasound was suggestive of benign solitary lesion of size 16 cm × 10 cm. Core biopsy was suggestive of phyllodes tumor, and the histopathology report of previous surgery was also suggestive of phyllodes tumor. Wide excision of the tumor and reconstruction was done with batwing mastopexy and with a slight modification of the described technique so that to avoid contralateral reduction mammoplasty in a young unmarried girl. Postoperative histopathology was suggestive of fibroadenoma measuring 15 cm × 8 cm with all margins free of tumor, and it is probably one of the biggest fibroadenomas reported so far. On follow-up, no significant disparity noted between the appearances of both breasts

Comparision of the effect between Mammotome assisted minimally invasive atherectomy and traditional surgery in treatment of youth giant breast fibroadenoma / 中华内分泌外科杂志

Objective To compare the effect between Mammotome minimally invasive surgery and traditional surgery in resection of youth giant breast fibroadenoma (YGBF).Methods We randomly selected 73 patients who had YGBF and already accepted surgical treatment in our hospital from Jul.2009 to Jan.2016.The 75 patients recruited from screening programmes were alloted to either treatment according to their choice (37 cases in MS and 38 cases in traditional surgery).The median follow-up was 18 months (from 6 to 36 months).Comparative analysis was done between the two groups in operation time,incision healing time,incision length,intraoperative bleeding,wound infection,subcutaneous hematoma,residual tumor,breast deformation,scar size,and patient satisfaction degree.Results There was no statisticaly significant difference betwen these two groups in operation time,intraoperative blood loss,incision infection,subcutaneous hematoma,or residual tumor (P＞0.05),however,MS group was superior to traditional surgery group in the incision healing time,incision length,breast deformation,scar size and postoperative satisfaction degree,and the difference was statistically significant(P＜ 0.05).Conclusion The advantage of Mammotome minimally invasive operation auxiliary for YGBF is obvious,such as fast wound healing,small incision,infection rate,small breast without deformation and scar etc.,also higher satisfaction degree to the treatment,which is regarded as the preferred surgical treatment for YGBF patients.

Fibroadenoma gigante juvenil: reporte de un caso / Giant juvenile fibroadenoma: Case report

Resumen ANTECEDENTES: El fibroadenoma gigante es raro; suele aparecer en mujeres entre 10 y 18 años. Se caracteriza por el crecimiento rápido de una tumoración encapsulada. De 0.5 a 4% corresponden a una forma especial descrita como fibroadenoma gigante o juvenil. La ecografía es el método de elección para el diagnóstico primario. Si bien la causa principal de una masa asimétrica mamaria en niñas es benigna, la extirpación quirúrgica temprana es la mejor manera de asegurar un buen resultado estético. CASO CLÍNICO: Paciente femenina de 12 años, llevada a la consulta debido al aumento de tamaño de la mama izquierda en el lapso de los tres meses previos. Sin antecedentes personales de importancia, sin cirugías previas, sin consumo de medicamentos y sin alergias conocidas. En la exploración física se apreció la asimetría de las mamas debido al aumento de tamaño de la izquierda; la forma de la areola y el pezón sin alteraciones. Se palpó una tumoración de bordes delimitados, consistencia homogénea blanda que ocupaba toda la glándula mamaria de aproximadamente 20 cm. CONCLUSIONES: El fibroadenoma juvenil es una lesión de crecimiento rápido y exponencial que distorsiona la asimetría y afecta la calidad de vida de la paciente. Es importante establecer el diagnóstico diferencial con tumoraciones mamarias para poder aclarar las dudas de nuestras pacientes acerca de su pronóstico. En pacientes jóvenes es importante tener en cuenta un solo acceso para la reconstrucción.

Abstract BACKGROUND: Giant fibroadenoma is rare; It usually appears in women between 10 and 18 years old. It is characterized by the rapid growth of an encapsulated tumor. From 0.5 to 4% correspond to a special form described as giant or juvenile fibroadenoma. Ultrasound is the method of choice for primary diagnosis. Although the main cause of an asymmetric mammary mass in girls is benign, early surgical removal is the best way to ensure a good aesthetic result. CLINICAL CASE: Female patient of 12 years, taken to the consultation due to the in-crease in size of the left breast in the span of the three previous months. No significant personal history, no previous surgeries, no medication and no known allergies. On physical examination, the asymmetry of the breasts was seen due to the increase in size of the left; the shape of the areola and nipple without alterations. A tumor of delimited edges was palpated, smooth homogenous consistency that occupied the entire mam-mary gland of approximately 20 cm. CONCLUSIONS: The juvenile fibroadenoma is a rapidly growing and exponential lesion that distorts the asymmetry and affects the quality of life of the patient. It is important to establish the difference diagnosis with mammary tumors in order to clarify the doubts of our patients about their prognosis. In young patients it is important to consider only one access for reconstruction.

Fibroadenoma gigante juvenil de mama: presentación de un caso clínico / Giant juvenile fibroadenoma of the breast: a clinical case

El fibroadenoma gigante juvenil es un tumor de mama benigno y una variante rara de los fibroadenomas. La presentación clínica suele ser una masa tumoral indolora en la mama, aislada y unilateral. Representa entre el 0, 5% y el 2% de todos los fibroadenomas y se desconoce su etiología precisa. Sin embargo, se cree que las hormonas son factores contribuyentes. En este artículo presentamos el caso de un fibroadenoma gigante juvenil de 20 cm de diámetro en la mama de una niña de 14 años. La paciente tenía una masa tumoral indolora, que se había agrandado progresivamente durante 1 año. La ecografía reveló la presencia de un fibroadenoma y se realizó una excisión quirúrgica. Tras diez meses de seguimiento, la paciente se encuentra bien.

Juvenile giant fibroadenoma is a benign breast tumor and rare variant of the fibroadenomas. Clinical presentation is usually a painless, solitary and unilateral breast mass. It accounts for 0.5%-2% of all fibroadenomas and exact etiology is not known; however, hormonal influences are thought to be contributing factors. We present a case of a 20 cm diameter giant juvenile fibroadenoma of the breast in a 14-year-old girl. The patient was suffering from a painless, progressively enlarging mass for 1 year. Ultrasound revealed fibroadenoma and total surgical excision was performed. The patient is doing well in ten months of follow up.

Giant fibroadenoma or juvenile fibroadenoma of breast: Conservative surgery.

A 10 years prepubertal age girl presented with huge 17 X 14 cm painless breast lump of four months duration. Based on the cytological, imaging and clinical findings a preliminary diagnosis of benign proliferative breast lesion closest to giant fibroadenoma was offered. Giant fibroadenomas are rare in young girls and are difficult to differentiate from low grade phylloides tumor by cytology/ imaging. Giant fibroadenomas have to be differentiated from phylloides tumor by the lack of leaf-like structures and stromal cell atypia and from the breast hamartoma and asymmetric breast hypertrophy in girls by the lack of mammary lobules. Giant fibroadenoma should take its due place in the diagnostic algorithm of the breast tumors. Marginal excision with nipple areola sparing and close follow up should be the standard of treatment in young girls.

Fibroadenoma gigante en una adolescente / Giant fibroadenoma in an adolescent

Se describe el caso clínico de una adolescente de 18 años de edad, quien había sido operada de un fibroadenoma en la mama derecha en el 2011, la cual fue ingresada en el Hospital Clinicoquirúrgico Universitario "Dr. Ambrosio Grillo Portuondo" de Santiago de Cuba por presentar crecimiento exagerado de esta en solo un mes. Teniendo en cuenta los resultados de los exámenes citológicos efectuados existía duda en cuanto al diagnóstico de fibroadenoma gigante juvenil o de tumor filodes benigno, de manera que se le realizó la mastectomía total simple, luego de lo cual evolucionó satisfactoriamente y egresó sin complicaciones.

The case report of a 18 year-old adolescent who had been operated due to a fibroadenoma in the right breast in 2011 and who was admitted in "Dr. Ambrosio Grillo Portuondo" Clinical Surgical University Hospital in Santiago de Cuba for presenting exaggerated growth of it in a month is described. Keeping in mind the results of the cytology examinations carried out, there was doubt for the diagnosis of giant juvenile fibroadenoma or of benign phyllodes tumor, so that the simple total mastectomy was carried out, after which she had a satisfactory clinical course and she was discharged without complications.

Periareolar Incision in the Treatment of Multiple or Giant Fibroadenoma of the Breast / 中国微创外科杂志

7 cm in diameter)of the breast were treated in our hospital by lumpectomy via a periareolar incision.The length of the incision was less than half of the perimeter of the areola.For multiple fibroadenomas,circumareolar incision(not longer than half of the nipple-areolar perimeter)was made in different quadrants according to the position of the main tumor,so that the multiple benign tumors could be integrally removed through the approach between the hypodermic fat and glands via radial incisions.Similarly,giant benign tumors were treated through the same approach,cut into pieces,and then removed.Results Totally 165 tumors were removed from the 46 patients with multiple fibroadenomas.In the resected masses,19 were from one patient,who had bilateral multiple breast tumors.The 2 patients with giant breast fibroadenoma were also cured by lumpectomy,the diameter of the largest tumor in the two was 8 cm,while the circumareolar incisions were shorter than 3.5 cm.No nipple necrosis occurred after the operation in our series.Follow-up was achieved in all of the patients for 1 month to 2 years(mean,14.4 months),during which,11 cases showed no incision scar,26 had non-notable scars,9 cases developed observable incision scars,and 2 cases had apparent scars owing to their susceptibility to scar.Conclusions Lumpectomy via minor circumareolar incision is convenient and effective for multiple or giant benign fibroadenoma of the breast with good cosmetic outcomes.