A Case Study of Gestational Gigantomastia

Abstract

Gestational gigantomastia is a rare condition characterized by rapid breast growth during pregnancy. The increased breast size leads to pain, ulceration, infection, bleeding, necrosis, and difficulty with mobility and can be fatal. Management is challenging and requires pain control, extensive wound care, psychological counseling, and surgical intervention. This case of bilateral gestational gigantomastia resulted in pregnancy termination. A 33-year-old woman presented to the quaternary academic medical center with gigantomastia at 15 weeks gestation. On presentation, her breasts were erythematous, firm, and tender. Laboratory findings included hypercalcemia; decreased intact parathyroid hormone levels; and elevated white blood cells, lactate levels, and parathyroid hormone-related protein. She reported severe constipation, anorexia, visual changes, headache, and fatigue. Diagnostic studies included abdominal and thyroid ultrasounds, chest computed tomography, and biopsy of chest wall tissue mass. Nephrolithiasis, breast hyperplasia, and axillary lymphadenopathy were confirmed. Treatment was initiated with intravenous fluids and calcitonin. The breast mass continued to grow, and she developed venous stasis ulcers that required frequent wound care. She agreed to pregnancy termination because of worsening gigantomastia and potentially poor surgical outcomes related to increased risk of hemorrhage. Interdisciplinary collaboration was imperative for provision of holistic care and successful patient outcomes. Nurse accountability for patient education and emotional support continued throughout an extensive hospitalization. Nurses supported the woman through the difficult decision to terminate her pregnancy, provided anticipatory guidance regarding probable mastectomies, and offered coping strategies for separation anxiety.