RESUMEN
We report a case of breast gigantism in a patient with Wilson's disease treated with penicillamine. A 19-year-old female with alleged Wilson's disease visited our hospital due to diffuse enlargement of both breasts. She had been treated with penicillamine 1,000 mg/day since her age of 15 after diagnosis of Wilson's disease. At the initial presentation, there were diffuse skin thickenings in both lower inner breasts and huge lesion which replaced almost all the breast parenchyma. After gun biopsy and excision for tissue diagnosis, fibroadenoma with ductal epithelial hyperplasia was diagnosed. Although daily dose of penicillamine was lowed to 500 mg/day, her symptom progressed. After 1 year of follow up, she and her parents strongly wanted to remove her breasts because of distorted body shape and weight of breasts. The patients underwent subcutaneous mastectomy with the designed incision of the reduction mammoplasty for the future mammoplasty. Although the breast gigantism is a rare side effect of penicillamine, female patients should be followed up cautiously for the possible change of breasts. Because penicillamine is no more the first choice for Wilson's disease, it would be better to avoid using penicillamine for Wilson's disease patients especially for the young females.
Asunto(s)
Femenino , Humanos , Adulto Joven , Biopsia , Mama , Diagnóstico , Fibroadenoma , Estudios de Seguimiento , Gigantismo , Degeneración Hepatolenticular , Hiperplasia , Mamoplastia , Mastectomía Subcutánea , Padres , Penicilamina , PielRESUMEN
We report a case of breast gigantism in a patient with Wilson's disease treated with penicillamine. A 19-year-old female with alleged Wilson's disease visited our hospital due to diffuse enlargement of both breasts. She had been treated with penicillamine 1,000 mg/day since her age of 15 after diagnosis of Wilson's disease. At the initial presentation, there were diffuse skin thickenings in both lower inner breasts and huge lesion which replaced almost all the breast parenchyma. After gun biopsy and excision for tissue diagnosis, fibroadenoma with ductal epithelial hyperplasia was diagnosed. Although daily dose of penicillamine was lowed to 500 mg/day, her symptom progressed. After 1 year of follow up, she and her parents strongly wanted to remove her breasts because of distorted body shape and weight of breasts. The patients underwent subcutaneous mastectomy with the designed incision of the reduction mammoplasty for the future mammoplasty. Although the breast gigantism is a rare side effect of penicillamine, female patients should be followed up cautiously for the possible change of breasts. Because penicillamine is no more the first choice for Wilson's disease, it would be better to avoid using penicillamine for Wilson's disease patients especially for the young females.
Asunto(s)
Femenino , Humanos , Adulto Joven , Biopsia , Mama , Diagnóstico , Fibroadenoma , Estudios de Seguimiento , Gigantismo , Degeneración Hepatolenticular , Hiperplasia , Mamoplastia , Mastectomía Subcutánea , Padres , Penicilamina , PielRESUMEN
D-penicillamine, a chelating agent of copper, is the drug of choice for the treatment of Wilson's disease. Breast enlargement is a rare complication arising from its use, and we report a case of breast gigantism which developed after it had been used for ten months to treat this condition. Mammography demonstrated bilaterally enlarged dense breasts; ultrasonography, similarly, demonstrated enlargement, revealing the presence of a mass, shown at biopsy to be benign, in the left one.