Giant Juvenile Fibroadenoma Research Articles

Bilateral gigantomastia due to benign breast tumors: a case series and brief review focusing on bilateral diffuse pseudoangiomatous stromal hyperplasia

Gigantomastia is a rare condition characterized by excessive hypertrophy of the connective tissue of the breast, which can cause physical and emotional distress. Surgical intervention is crucial for improving patients’ quality of life; however, it is challenging to balance minimizing the risk of recurrence and maximizing favorable aesthetic outcomes. This study documents the successful management of three rare cases of bilateral gigantomastia resulting from benign tumors. These cases included rapidly growing bilateral diffuse tumorous pseudoangiomatous stromal hyperplasia (PASH) and bilateral juvenile giant fibroadenoma, with no long-term recurrence observed. We discuss the diagnostic challenges and management considerations for gigantomastia, with a focus on reviewing PASH and its differential diagnosis. The findings offer valuable insights into the successful management of diverse gigantomastia cases caused by benign tumors, potentially aiding clinicians in making more informed decisions regarding optimal patient care.

Giant juvenile fibroadenoma in a 15-year-old Nigerian female: A case report with review of literature

Introduction
 Breast mases in female adolescents are rare and consist mainly of developmental lesions and benign tumours.1 The benign tumours seen are mostly fibroadenoma which is the most common breast tumour seen in adolescent females.2 It may present as solitary or multicentric tumour.3 It may also vary in size and is designated as giant juvenile fibroadenoma “GJF” if it is greater than 5cm, 500g or replaces at least 80% of the breast tissue.3 GJF accounts for 1-8% of breast lesions in the adolescent population.3,4 Overall, giant fibroadenoma accounts for 0.5-2% of all fibroadenomas.4 We present a case of GJF in a 15-year-old female who was managed in our clinical setting.

Importancia del diagnóstico diferencial de los tumores fibroepiteliales mamarios en adolescentes. Descripción de un caso

Fibroadenoma is the most common benign fibroepithelial lesion of the breast in young women, accounting for around 90% of solid lesions of the gland in adolescence. However, juvenile giant fibroadenoma is a rare condition of the mammary gland, which mainly affects women under 18 years of age. Due to the similarity of the clinical characteristics of juvenile giant fibroadenoma and phyllodes tumor, in addition to the rapid growth of both. Entities, it is important to establish the differential diagnóstico of both pathologies when one of them is suspected, in order to guarantee the most appropriate therapeutic approach. A 14-year-old adolescent with no family or personal history of interest, who was referred to our clinic in September 2021 in view of ultrasound findings due to presenting breast asymmetry at the expense of a 5-month-old left breast nodule. An ultrasound-guided core needle biopsy was performed with the result of giant juvenile fibroadenoma. Lumpectomy was performed. Histopathological diagnóstico compatible with juvenile giant fibroadenoma of the left breast. Based on the consulted bibliography and our experience, an early and precise differential diagnóstico, together with surgical removal for a correct characterization would be the most appropriate management of these patients. The surgical tactics and technique depend on the age at the time of diagnóstico, the clinical and radiological characteristics of the mammary gland and the tumor, and even the wishes of the patient.

Giant Juvenile Fibroadenoma: Case Report and Review of the Literature.

Fibroadenomas are common benign breast tumors. Fibroadenomas that exceed 5 cm in diameter, weigh more than 500 g, or replace more than four-fifths of the breast are characterized as giant. A fibroadenoma diagnosed in patients during childhood or adolescence is characterized as juvenile. An extensive PubMed search of the literature in English up until August 2022 was performed. In addition, a rare case of a gigantic fibroadenoma in an 11-year-old premenarchal girl who was referred to our adolescent gynecology center is presented here. Eighty-seven cases of giant juvenile fibroadenomas have been reported in the literature along with our case. Patients with giant juvenile fibroadenoma presented at a mean age of 13.92 years and usually after menarche. Juvenile fibroadenomas are usually unilateral, occurring either in the right or the left breast; the majority of them are diagnosed when they are already more than 10 cm in size, and they are most frequently treated with total lump excision. Differential diagnosis includes phyllodes tumors and pseudo-angiomatous stromal hyperplasia. Conservative management is feasible, but surgical excision is recommended to patients with suspicious imaging features or when the mass grows rapidly.

Juvenile Giant Fibroadenoma Vs. Phyllodes Tumor: Know the Difference in a 14-Years-Old Woman: Case Report

Fibroadenoma is the most common benign fibroepithelial lesion of the breast in young women, accounting for around 90% of solid lesions of the gland in adolescence. However, juvenile giant fibroadenoma is a rare breast condition that occurs in women under 18 years of age. Due to the similarity of the characteristics of juvenile giant fibroadenoma and phyllodes tumor, both lesions characterized by rapid growth, it is important to establish the differential diagnosis of both pathologies when one of them is suspected, in order to guarantee the most appropriate therapeutic attitude to follow. A 14-year-old woman with no family or personal history of interest, who consulted due to a clinical picture characterized by breast asymmetry secondary to progressive growth of the left breast of 5 months of evolution. An ultrasound-guided core needle biopsy was performed that reported giant juvenile fibroadenoma. Lumpectomy was performed. Histopathological diagnosis compatible with juvenile giant fibroadenoma of the left breast. Based on our case and on the reviewed bibliography, we recommend an early differential diagnosis, as well as an accurate one, and surgical treatment of cases of juvenile giant fibroadenoma. The surgical tactics and technique depend on the age at the time of diagnosis, the clinical and imaging characteristics of the mammary gland and the tumor, as well as the wishes of the patient in question.

A Case of Juvenile Giant Fibroadenoma of Breast: A Diagnostic Dilemma

Fibroadenomas are the most common type of breast tumours diagnosed in young women. Fibroadenomas found in children and adolescents are termed as juvenile fibroadenomas of which giant fibroadenomas are rare account for 0.5%-2% of all fibroadenomas, that cause asymmetry of the breasts and are characterised by rapidly growing mass of more than 5 cm in greatest dimension, and/ or weight more than 500 gm, or replaces at least 80% of the breast. Both phyllodes tumour and giant fibroadenoma have similar clinical presentations. The current case is of 15-year-old female with a rapidly growing mass in the left breast with in a span of six month duration measuring 15×10 cm and was associated with dilated veins over it. The clinical diagnosis was suggestive of phyllodes tumour. Cytopathological and histopathological reports showed the evidence of juvenile giant fibroadenoma. Hence, the purpose of this report is to differentiate phyllodes tumour from juvenile giant fibroadenoma preoperatively to obtain the best cosmetic outcome for a developing breast lesion.

Bilateral Giant Juvenile Fibroadenoma of the Breast Developing Metachronously in a 10-Year-Old Girl

Abstract Giant juvenile fibroadenoma (GJF) is very rare and represents about 0.5% of all fibroadenomas. We describe a case of a 10-year-old premenarche girl that presented with huge bilateral GJFs. The right breast mass appeared first and was managed accordingly. The left mass developed rapidly within three months necessitating a second subtotal mastectomy.

MED 12 gene mutation in a case of bilateral giant juvenile fibroadenoma

Giant juvenile fibroadenoma is a rare variant of more common benign lesion, fibro adenoma observed in younger population. They present with rapidly enlarging single or multiple breast masses in one or both the breast. A 10-year-old pre-pubertal girl presented with large lump in left breast followed by right breast lump. FNAC was suggestive of fibroadenoma, and histopathology confirmed the diagnosis. To understand the genetic basis of common entity like fibroadenoma with a rare presentation in very young age, the tissue block was subjected to gene sequencing and identified MED 12 gene mutation. It leads us to the possibility of new treatment modalities of targeting the causative gene and thus sparing the patient from invasive procedures.

Premenarche bilateral giant juvenile fibroadenoma of breast: literature review with a case report

Fibroadenoma is a common abnormality which every surgeon has been exposed to, and there are several international guidelines regarding its management. However giant fibroadenomas, especially in the premenarche setting has been a rare occurrence, even for the experienced surgeon. Various reports have shown that we need to treat this condition more aggressively than the normal fibroadenoma, and issues of cosmesis in a developing breast along with the aim to preserve lactation functionality becomes an issue. Since these cases remain a single life time experience for most surgeons, there is a sparsity of treatment protocols even in literature. Through this paper we hope to shed some valuable insight to this rare disorder and help surgeon colleagues, when dealing with similar cases.

Breast reconstruction using a tissue expander after enucleation of a giant fibroadenoma: A case report.

IntroductionFibroadenomas are among the most common benign tumors in women. Juvenile giant fibroadenomas account for nearly 0.5% of all fibroadenomas. Due to its size, a giant juvenile fibroadenoma leaves a large defect or deformity after its resection. The optimal surgical management strategy for giant juvenile fibroadenomas remains unclear. Here, we report a case of successful breast reconstruction without residual deformity through gradual deflation of a saline-filled tissue expander after resection of a giant juvenile fibroadenoma.Presentation of caseA 14-year-old girl with a growing tumor in her left breast presented to a private clinic. Given that the tumor was 8 cm in size, phyllodes could not be ruled out. Consequently, she was referred to our hospital for further examination and treatment. Core needle biopsy confirmed the tumor to be a fibroadenoma. We resected the tumor and inserted a tissue expander filled with 120 mL of saline, matching the area of the large defect caused by tumor resection. We removed approximately 25 mL of saline every 3 weeks to aid normal mammary tissue enlargement. After completely draining saline from the tissue expander and confirming an acceptable enlargement of the residual mammary gland, we performed an operation to remove the tissue expander. Follow-up revealed that the symmetry and contour of the breast were excellent after the second operation.ConclusionsOur observations suggest that using a tissue expander to enlarge normal mammary tissue may help reconstruct large defects caused by excision of benign tumors.

Breast-conserving surgery in giant juvenile fibroadenoma: a case report

: Giant juvenile fibroadenoma (GJF) represents 0.5% of fibroadenomas and the usual age range of occurrence is 10 to 18. GJF definition describes a benign tumor that measures more than 5 cm, weighs more than 500 grams or occupies more than 80% of the mammary gland. In this report, we present the case of a 14-year-old patient’s GJF with six months of evolution. The examination proved skin and the Nipple-Areola Complex (NAC) involve, resulting in the identification of a smooth, firm and mobile tumor of 20 cm with negative local lymph nodes. The diagnosis used Mammography (MG), Ultrasound (US), and Magnetic Resonance Imaging (MRI). In addition, Breast Conservative Surgery (BCS) required making an incision in the breast groove, resulting in good aesthetic results. To the best of our knowledge, there is no standard surgical approach. In practice, the treatment options for BCS are enucleation, Wide Local Excision (WLE) and oncoplastic techniques, and Simple Mastectomy (SM) considering or excluding reconstruction. This case challenged medicine itself since human skin gained elasticity after six months, it did not reach full breast development, and hormonal action exposition was present all time, which can generate recurrences, for instance, pregnancy or psychological factors. Whilst GJF is a pathology that requires Therapeutic Board (TB) criteria for adequate BCS, it needs a multidisciplinary team including a Gynecology Oncologist specialist, Plastic and Reconstructive Surgery (PRS) specialist, and a psychologist, where the aesthetic result of the patient should always be priority. This case shows the importance of making adequate differential diagnosis (DD) and respecting oncological principles. In a year of follow-up, skin retraction improved due to normal breast development suggesting effectiveness of the technique.

Fibroadenoma gigante juvenil y cirugía de reconstrucción: reporte de un caso y revisión de la bibliografía

Fibroadenoma is the most common benign breast lesion in young women, being the giant juvenile fibroadenoma an entity that appears mainly in those under 25 years. With an etiology currently not well established, it is described as a mass type lesion greater than 5cm or that occupies more than 80% of the breast and presents significant growth, with the physical and psychological consequences that this entails. Despite being a benign lesion, its fast evolution and growth makes it necessary to rule out malignancy, which occurs in less than 0.2% of the cases. The diagnosis is based on a correct anamnesis, physical examination and complementary tests, preferable with ultrasound. The anatomopathological study by biopsy allows to confirm the clinical diagnosis of benignity or to rule out malignancy in the event of a suspicious evolution. Its management is surgical and consists of complete excision of the lesion, varying the surgical technique performed (from conservative surgery to mastectomy with reconstruction) according to the size of the lesion, the characteristics of the breast, and the age of the patient.

A giant juvenile fibroadenoma in a 12-year-old girl: Case report and brief literature review

Juvenile fibroadenoma is the most common breast mass in adolescents accounting for 0.5–4% of all cases of fibroadenomas. Giant fibroadenomas are rare variants and represent only 0.5% of all fibroadenomas, usually occurring in girls between the ages of 10 and 18. They are characterized by massive and rapid enlargement of a rubbery, mobile, and non-tender mass and defined as being larger than 5 cm or weighing more than 500 g. The aetiology is not well understood and is believed to be an increased sensitivity to normal oestrogen level. We present a 12-year-old Asian girl treated at the age of 8 for idiopathic precocious puberty, without known family history of breast masses or cancers, who developed spontaneous giant fibro-adenoma measuring 15cm X 17 cm. The patient was further evaluated via ultrasonography showing a sole large lesion of 15 X 17 cm in the left breast. Surgical excision with conservation of the developing breast parenchyma and nipple-areolar complex under general anaesthesia was performed. Histopathological findings after the surgical excision were suggestive of juvenile fibroadenoma. The patient has a normal breast development throughout 4 years follow-up. The rapid growth of a breast mass in such young patients can be of great concern causing a considerable impact on these patients’ psychological and emotional condition. One of the most important concerns is the impact on potential future mammary gland development. Therefore, it is crucial to promptly rule out malignant processes or phyllodes tumors and educate young patients and their families on treatment options that fit their concerns. In addition, the final cosmetic result is essential after the surgical excision; although the primary cause of asymmetrical breast enlargement is a benign mass, early surgical excision is efficient concerning the best possible cosmetic outcome. Keywords: Breast mass; juvenile fibroadenoma; giant fibroadenoma.

Giant juvenile fibroadenoma: experience from a rural medical college

Giant juvenile fibroadenoma: experience from a rural medical college

Giant Juvenile Fibroadenoma in a Young Female-A Diagnostic Dilemma

Background: Fibroadenoma is the most common breast lesion among pediatric female population. A giant fibroadenoma is rare, characterized by a rapidly growing tumor, with a mass >5 cm diameter in greatest dimension and/or weighing more than 500 gm. Phyllodes tumor range from benign to malignant. Both have similar presentation. Clinical Description: An 11-year-old girl presented with rapidly progressive, painless increase in the size of the left breast over 2 months. Local examination revealed a firm nontender mass involving the upper inner and outer quadrants of the left breast along with the retro-areolar region. The mass was mobile and measured approximately 11 cm × 10 cm. The overlying skin was normal, although with dilated veins and free from underlying mass. The clinical phenotype was suggestive a phyllodes tumor in view of rapid progression and large size. However, the ultrasonogram and fine-needle aspiration cytology favored a fibroadenoma. Management: It was decided to perform a “Nipple-areolar complex sparing lumpectomy” with deferment of reconstructive surgery. Adequate lump excision was achieved while maintaining proper cosmesis. The histopathological findings of the excision biopsy confirmed the final diagnosis of fibroadenoma. Conclusion: A large breast mass in a pediatric/adolescent girl poses a diagnostic dilemma to the treating surgeon. Proper evaluation is needed to differentiate between several benign breast masses from malignant ones. The definitive diagnosis is made histologically. Total excision of the lump with conservation of nipple and areola is indicated to make a definitive diagnosis and to relieve the compression of the normal breast tissue.

A giant juvenile fibroadenoma in a 16-year-old girl: a case report

A giant juvenile fibroadenoma in a 16-year-old girl: a case report

TREATMENT OF GIANT JUVENILE BREAST FIBROADENOMA BY SINGLE HOLE BREAST ENDOSCOPY: A CASE REPORT.

TREATMENT OF GIANT JUVENILE BREAST FIBROADENOMA BY SINGLE HOLE BREAST ENDOSCOPY: A CASE REPORT.

Dev juvenil fibroadenomun yönetiminde batwing mastopeksi yöntemi ile birlikte meme koruyucu cerrahi: 12 yaşinda kız olgu sunumu

Fibroadenomas are benign breast tumours consisting of epithelial and stromal components. Most of them are about 1 to 2cm in size. It is defined as “giant” when the fibroadenoma is larger than 5cm, weighs more than 500 g or occupies for at least 80% of breast volume. It is usually encountered in patients of less than 20 years of age. Progressively growing mass and its large size cause a suspicion of malignancy. It presents as unilateral macromastia that causes breast asymmetry. Excellent cosmetic results cannot be obtained with simple excision in this situation. We aimed to present a case of a 12-year-old patient with a diagnosis of giant juvenile fibroadenoma. In this case, we performed surgical excision with Batwing mastopexy of the breast to achieve optimal symmetry with contralateral breast.

Giant Juvenile Fibroadenoma of the Breast: Clinical Manifestation in Two Cases

Giant Juvenile Fibroadenoma of the Breast: Clinical Manifestation in Two Cases

Lipomodelling of the Breast Following Excision of a Giant Juvenile Fibroadenoma

Giant juvenile fibroadenomas form 1-8% of breast lesions in the adolescent population. We report a case of giant fibroadenoma in a 17-year-old girl who underwent simple lump excision through a lateral breast fold incision followed by lipomodelling to correct the dimpling of the breast. With this dual approach, excellent cosmetic outcome can be achieved for average-sized giant fibroadenoma without the need for more complex technique.