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Bhargava A, Khan IA, Tote D, Zade A, Manek YB. A Unique Presentation of a Giant Fibroadenoma in a Perimenopausal Female. Cureus 2024; 16:e60189. [PMID: 38868246 PMCID: PMC11167588 DOI: 10.7759/cureus.60189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2024] [Accepted: 05/13/2024] [Indexed: 06/14/2024] Open
Abstract
Giant fibroadenomas are common in young females and are rarely reported in perimenopausal or menopausal females. These fibroadenomas are observed as single, mobile, small to large, with distinct boundaries. These tumors are hyperplastic and characterized by their aberrant growth in both the epidermal and mesenchymal layers, which can be accompanied by pain in some instances. These tumors have similar clinical resemblances to other epithelial and stromal tumors, such as phyllodes tumors, except for the level of disease severity and malignancy. Treatment of giant fibroadenomas includes surgical resection. Surgical excision is done by complete excision of the fibroadenoma, with the rest of the breast tissue and the nipple-areolar complex preserved. Timely diagnosis can be helpful in the prevention of adverse outcomes. This is a case of a 40-year-old female who presented with a lump in her right breast, for which she underwent a wide local excision. On histopathology, it was found to be a giant fibroadenoma. Her postoperative recovery was uneventful.
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Affiliation(s)
- Abhilasha Bhargava
- General Surgery, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Imran Ali Khan
- General Surgery, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Darshana Tote
- General Surgery, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Anup Zade
- General Surgery, Mahatma Gandhi Institute of Medical Sciences, Wardha, IND
| | - Yogesh B Manek
- General Surgery, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Brouwer de Koning IM, van Heusden HC, Mol SJJ, Rots ML, Draaisma WA, Bosscha K. A rapidly growing fibroadenoma in a pregnant woman: A case report. Breast Dis 2023; 42:325-330. [PMID: 37899052 DOI: 10.3233/bd-230030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2023]
Abstract
BACKGROUND Fibroadenomas are the most common benign breast lesions in women. They present as a unilateral mass and can rapidly enlarge in size through hormonal changes. Fibroadenomas could be classified as small or giant, and as simple or complex. They are classified as 'giant' when the size exceeds 5 cm and/or weight 500 gram; and as 'complex' if one of the following characteristics is present: cysts with a size >3 mm, epithelial calcifications, sclerosing adenosis and papillary apocrine metaplasia. Giant fibroadenomas can cause compression of surrounding breast tissue or breast asymmetry, requiring surgical excision in order to preserve a normal breast shape. CASE A 26-year-old pregnant woman was referred with a palpable mass of her right breast. The mass rapidly increased in size to a diameter of 13 cm during the second trimester of her pregnancy. A tru-cut biopsy confirmed a fibroadenoma. The rapid growth and compression of normal breast tissues indicated a lumpectomy during her pregnancy. The mass was easily excised without any consequences for the pregnancy. Pathological examination showed a complex giant fibroadenoma. CONCLUSION A unique case of a pregnant woman with rapid progression of a fibroadenoma that met the criteria of a complex and giant fibroadenoma, was presented. This case emphasizes the importance of timely surgical intervention, even during pregnancy, to prevent permanent breast tissue damage.
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Affiliation(s)
| | - H C van Heusden
- Department of Surgery, Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands
| | - S J J Mol
- Department of Pathology, Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands
| | - M L Rots
- Department of Surgery, Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands
| | - W A Draaisma
- Department of Surgery, Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands
| | - K Bosscha
- Department of Surgery, Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands
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Discrimination between phyllodes tumor and fibro-adenoma: Does artificial intelligence-aided mammograms have an impact? THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2022. [DOI: 10.1186/s43055-022-00734-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
The indulgence of artificial intelligence (AI) has been considered recently in the work up for the detection and diagnosis of breast cancer through algorithms that could supply diagnosis as the radiologist do. The algorithm learns from a supervised and continuous input of large and new data sets unlike the standard programming, which requires clear step-by-step instructions. The aim of this study is to assess the ability of AI scanned mammograms to aid the ultrasound in the discrimination between phyllodes tumors and fibro-adenomas.
Results
This is a retrospective analysis included 374 proven phyllodes tumors (PT) and fibro-adenomas (FA). Digital mammogram and breast ultrasound was performed for all the cases and each breast was given a “Breast Imaging Reporting and Data System” (BI-RADS) score. Included mammograms were scanned by AI with resultant a qualitative heatmap and a quantitative abnormality scoring of suspicion percentage.
The study included 164 PT (43.9%) and 210 FA (56.1%). BI-RADS category 2 was assigned in 40.1%, category 3 in 38.2%, category 4 in 18.5% and category 5 in 3.2% with median value of the AI abnormality scoring of 23%, 44%, 65% and 90% respectively. Sensitivity and specificity of the conventional imaging were 59.2% and 75.8% respectively. The AI abnormality scoring of 49.5% upgraded the sensitivity to 89.6% and specificity to 94.8% in the ability to discriminate PT from FA masses.
Conclusion
Artificial intelligence-aided mammograms could be used as method of distinction between PT from FA detected on sono-mammogram. The color hue and the quantification of the abnormality scoring percentage could be used as a one setting method for specification and so guide clinicians in their decision of conservative management or the choice of the surgical procedure.
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Martins LM, Barros IS, Ferreira EDS, Silva Neto AGD, Dourado CSDME, Oliveira VAD, Oliveira ARSD, Morais JBS, Marreiro DDN, Silva BBD. Expression of metalloproteinases 2 and 9 and plasma zinc concentrations in women with fibroadenoma. Rev Assoc Med Bras (1992) 2021; 67:806-810. [DOI: 10.1590/1806-9282.20201015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 03/14/2021] [Indexed: 11/22/2022] Open
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Jena S, Sinha NK. Use of Lateral Oncoplasty for Multiquadrant Giant Fibroadenoma: A Novel Approach. Cureus 2021; 13:e15090. [PMID: 34155459 PMCID: PMC8210705 DOI: 10.7759/cureus.15090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Giant fibroadenomas are uncommon benign lesions, defined as fibroadenomas of >5 cm in size and/or weighing more than 500 g. They can distort the shape of the breast and cause asymmetry, so they should be excised. Here, we report two cases of giant fibroadenoma, where wide local excision and reconstruction with lateral oncoplasty were done. Compared to all previous reports of patients with giant fibroadenoma, where the lump was excised either through a submammary incision or by round block technique depending on the location of the tumour, we used the lateral oncoplasty technique in both patients. Lateral oncoplasty is a new reconstructive option to maintain cosmesis and symmetry after the excision of giant fibroadenomas in the outer and central quadrants of the breast. It is a good option for reconstruction in cases where the defect is very large and facilities for conventional flap surgeries are not available.
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Nigam JS, Tewari P, Prasad T, Kumar T, Kumar A. Carcinoma Breast-Like Giant Complex Fibroadenoma: A Clinical Masquerade. Cureus 2021; 13:e12611. [PMID: 33585101 PMCID: PMC7872482 DOI: 10.7759/cureus.12611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Fibroadenoma (FA) is a benign, painless, solid breast tumor that commonly occurs in young adult females. The term complex FA is used when it is associated with any of the following: cyst >3 mm, epithelial calcifications, sclerosing adenosis, or papillary apocrine metaplasia. FAs of size more than 5 cm or weighing more than 500 g are considered as giant FAs. Giant FAs are rare, and because of hormonal sensitivity, they commonly occur in pregnant or lactating women. We report the case of a 26-year-old female with a large breast mass that was clinically as well as grossly masquerading as breast carcinoma and turned out to be a giant complex FA on microscopy.
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Affiliation(s)
- Jitendra S Nigam
- Pathology/Lab Medicine, All India Institute of Medical Sciences, Patna, IND
| | - Prerna Tewari
- Pathology/Lab Medicine, All India Institute of Medical Sciences, Patna, IND
| | - Tanya Prasad
- Pathology/Lab Medicine, All India Institute of Medical Sciences, Patna, IND
| | - Tarun Kumar
- Pathology/Lab Medicine, All India Institute of Medical Sciences, Patna, IND
| | - Anil Kumar
- Surgery, All India Institute of Medical Sciences, Patna, IND
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Kabuyaya MK, Mutombo FL, Moseka FM, Kihemba K, Wetzig N, Lussy JP. A giant fibroadenoma in a mature woman: diagnosis and treatment in a limited resource environment (a case report). Pan Afr Med J 2021; 38:19. [PMID: 34650650 PMCID: PMC8488286 DOI: 10.11604/pamj.2021.38.19.26200] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 10/08/2020] [Indexed: 11/11/2022] Open
Abstract
We report an extremely rare case of a 40-year-old woman with a giant fibroadenoma of 30cm in diameter that was accompanied by ulceration and bleeding. We document the onset, the clinical presentation, as well as the challenge encountered in the diagnosis and managing in a limited resource environment.
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Affiliation(s)
- Médard Kakule Kabuyaya
- Department of Surgery, HEAL Africa Tertiary Hospital, Goma, Democratic Republic of Congo
- Department of Surgery, University of Goma (UNIGOM), Goma, Democratic Republic of Congo
| | - Fabrice Lele Mutombo
- Department of Surgery, HEAL Africa Tertiary Hospital, Goma, Democratic Republic of Congo
| | | | - Kasereka Kihemba
- Department of Pathology, HEAL Africa Tertiary Hospital, Goma, Democratic Republic of Congo
| | - Neil Wetzig
- Department of Surgery, HEAL Africa Tertiary Hospital, Goma, Democratic Republic of Congo
| | - Justin Paluku Lussy
- Department of Gynecology and Obstetrics, HEAL Africa Tertiary Hospital, Goma, Democratic Republic of Congo
- Department of Obstetrics and Gynecology, University of Goma (UNIGOM), Goma, Democratic Republic of Congo
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Sun C, Zhang W, Ma H, Han N, Qi M, Li D, Wang X, Wang X, Yang J. Main Traits of Breast Fibroadenoma Among Adolescent Girls. Cancer Biother Radiopharm 2020; 35:271-276. [PMID: 32267738 DOI: 10.1089/cbr.2019.3209] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Objective: To investigate the clinicopathological features of breast fibroadenoma among female teenagers and provide some bases for its diagnosis and treatment, the authors conducted this study. Methods: Retrospective analysis on 80 female teenagers with fibroadenoma was carried out. The histological sections of H&E were reviewed, and immunohistochemical staining with ki67, CD34, and SMA were performed. The patients were followed up. Results: The age of included patients ranged from 12 to 18 years old, with a mean age of 17. Bilateral lesions occurred in 10% of the patients, and mean tumor diameter was 2.8 cm. Histologically, tumors in most cases showed clear boundary with no capsule. Also, 90% of the cases were confirmed to be pericanalicular mixed types, while about 20% had atypical foliation structure. The mean density of mesenchymal cells was 30%. The upper limit of mitotic figure was 2/10HPF in 80% of the cases, and the positive index of ki-67 was no more than 5% in 80% of cases. Sixteen percent of the cases also simultaneously suffered epithelial micropapillary hyperplasia. Six cases (6/39, 15%) faced relapse after tumor resection, with an average recurrence interval of 4.9 years after surgery. Tumor size, mitotic activity, ki67 positive index, and the density of mesenchymal cells were not associated with relapse. Conclusions: Adolescent fibroadenoma is a group of biphasic breast tumors with unique clinical and pathological features. Although fibroadenoma shows a local recurrence rate to a certain degree, its recurrent lesions grow slowly.
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Affiliation(s)
- Chunjie Sun
- Department of Pathology and Tongzhou Maternal and Child Health Hospital of Beijing, Beijing , China
| | - Wanlong Zhang
- Department of Pathology and Tongzhou Maternal and Child Health Hospital of Beijing, Beijing , China.,Department of Traditional Chinese Medicine, Tongzhou Maternal and Child Health Hospital of Beijing, Beijing , China
| | - Haihui Ma
- Department of Obstetrics, Tongzhou Maternal and Child Health Hospital of Beijing, Beijing, China
| | - Na Han
- Department of Obstetrics, Tongzhou Maternal and Child Health Hospital of Beijing, Beijing, China
| | - Menghu Qi
- Department of Pediatrics, and Tongzhou Maternal and Child Health Hospital of Beijing, Beijing, China
| | - Donglian Li
- Department of Pathology and Tongzhou Maternal and Child Health Hospital of Beijing, Beijing , China
| | - Xiaojing Wang
- Department of Pathology and Tongzhou Maternal and Child Health Hospital of Beijing, Beijing , China
| | - Xuehui Wang
- Department of Pathology and Tongzhou Maternal and Child Health Hospital of Beijing, Beijing , China
| | - Jie Yang
- Department of Information, Tongzhou Maternal and Child Health Hospital of Beijing, Beijing, China
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