Application of periareolar mastopexy technique for giant phyllodes tumor resection in an adolescent female with breast asymmetry: a case report and literature review

Mahmoud A Hifny,Asmaa Gaber R,Mohamed Yousef A,Mohamed Abdelshafy Mohamed,Mahmoud Abdelhameid

doi:10.1186/s43046-020-00036-2

Mahmoud A Hifny, Asmaa Gaber R + Show 3 more

Open Access

https://doi.org/10.1186/s43046-020-00036-2

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Abstract

BackgroundThe phyllodes tumors are rare neoplastic disease which exhibits a benign behavior in adolescents female. After resection of a large benign breast tumor, insufficient breast contour may result with nipple areola complex malposition. As symmetry of the breast is psychologically extremely crucial, especially in adolescents, in such cases, an immediate mammoplasty-like breast reduction or mastopexy technique of the affected breast will be necessary to provide symmetry of the bilateral breasts at the initial surgery.Case presentationA 16-year-old woman reported rapid enlargement of a large mass in her left breast over 12 months. The physical examination revealed a huge mass that occupied the lower quadrants of her left breast causing expansion of both the overlying skin and the nipple areolar complex. A biopsy was constant with a benign phyllodes tumor. We have applied a periareolar mastopexy technique to allow tumor resection through exposure incision at the lower half of the outer periareolar circular incision. At the same time, we reduced the expanded skin envelope and mobilized the nipple–areola complex to restore breast symmetry.ConclusionThe periareolar mastopexy approach provides a wide surgical exposure, allows excision of benign giant breast tumor, and simultaneous restoration of the breast shape with favorable aesthetic results and minimal postoperative scarring.

Highlights

BackgroundThe Phyllodes tumor has reported as a rare neoplastic lesion in an female adolescent which account for about 1% of all breast lesions
The phyllodes tumors are rare neoplastic disease which exhibits a benign behavior in adolescents female
The Phyllodes tumor has reported as a rare neoplastic lesion in an female adolescent which account for about 1% of all breast lesions

Summary

Background

The Phyllodes tumor has reported as a rare neoplastic lesion in an female adolescent which account for about 1% of all breast lesions. After careful discussion about the best approach to provide an adequate access to the tumor excision as well as addressing the excess skin envelope after tumor excision, the periareolar mastopexy approach was planned. It provides exposure through incision at the lower half of the outer periarolar circular incision for tumor excision. The medial and lateral points (point C&D) are determined by the intended skin resection All these point was measured in comparison with normal contralateral breast dimensions (Fig. 1c). Through the preplanned full-thickness incision at the lower half of the outer periareolar circular incision, the phyllodes tumor was reached with an adequate and perfect view for resection with sufficient safety margin (Fig. 1d). Nipple– areola complex’s position, skin quality, and breast shape (Fig. 1g, h)

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Discussion

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