Gestational gigantomastia: A case report and brief review of the literature

Bilateral breast swelling in a pregnant woman with high-grade B-cell lymphoma, potentially Burkitt lymphoma

Primary breast Burkitt lymphoma is an aggressive subtype of non-Hodgkin lymphoma (NHL) and extremely rare. Burkitt lymphoma involving both breasts during pregnancy was a rare condition with fifteen cases reported in literature. We present a case of a 19-year-old 36 weeks pregnant woman who came for a check-up due to bilateral breast swelling. The final pathology with immunohistochemistry staining was high-grade B-cell lymphoma, potentially Burkitt lymphoma.

Gestational gigantomastia with pseudoangiomatous stromal hyperplasia - a case report of rare entities

Gestational gigantomastia (GG) is a rare and severe clinical complication of pregnancy. It is characterized by dramatic and uncontrolled growth of the breasts, often leading to physical discomfort, psychological distress and significant surgical complications. Its pathophysiology is poorly understood; management options include conservative pharmacological and surgical interventions. Pseudoangiomatous stromal hyperplasia of the breast is a very rare, incidental, and histological diagnosis seen predominantly in women aged 30-40 years old, with the management generally involving surgical excision. The authors herein discuss an unusual case of bilateral GG complicated by pseudoangiomatous stromal hyperplasia in a premenopausal Caribbean woman, which is the second reported case in this population, with the first reported by one of our authors.

Management of Gestational Gigantomastia with Goldilocks Procedure after Mastectomy: A Case Report and Review of Literature

Gestational gigantomastia is characterized by the rapid growth of breasts during pregnancy. The treatment method of gestational gigantomastia is unclear; if the medical treatment is ineffective, surgery is considered. However, sufficient research on which method is best to perform breast reconstruction for the gestational gigantomastia patient has not yet been conducted. Our patient was young and had aesthetic needs; thus, we did not recommend modified radical mastectomy. However, it was difficult for the patient to consider active reconstruction using an implant or autologous tissue because of the expected complications and economic problems. The patient had a thin body shape and very large breasts compared with the trunk. Therefore, breast volume was not significantly required after reconstruction. Additionally, we expected that a considerable portion of skin would remain after mastectomy as a tubular-shaped breast. It was expected that the Goldilocks technique would be sufficient to meet the patient's volume needs. Therefore, we proceeded with total mastectomy and reconstruction using the Goldilocks procedure. No complications were recorded after the operation; most of the patient's discomfort was resolved, and the shape and size of the breasts were satisfactory.

Lessons learned in severe axillary gestational gigantomastia

Gestational gigantomastia involving axillary breast tissue can be safely resected during pregnancy; early management is paramount in preventing progression and limiting impact on pregnancy.

A Systematic Literature Review of the Clinical Presentation, Management, and Outcome of Gestational Gigantomastia in the 21st Century

BACKGROUND

Gestational gigantomastia (GG) is an uncommon pregnancy condition, and the underlying cause of GG has yet to be determined. Medical management and surgery are two treatment options for GG, and breast reduction or mastectomy with delayed reconstruction is the only available surgical option. We have conducted this systematic review to summarize and critically analyze all the GG data in the literature.

METHODS

The preferred reporting items for systematic reviews and meta-analysis (PRISMA) guidelines were adhered to in reporting this article. A systematic search was conducted in February 2022 for published case reports and case series on GG using the PubMed, MEDLINE, and Cochrane databases. The following keywords were used: macromastia, gestational gigantomastia, and gestational.

RESULTS

A total of 639 articles were searched, and only 66 case reports published between 1962 and 2022 were included. The mean patient's age at presentation was 28.79 years old. The majority of the patients were in their first trimester (n = 23, 47%). The main complaint was rapid bilateral breast enlargement (n = 54, 80.59%). Bromocriptine was the most common medical management used (n = 19/35, 54.28%). Bilateral breast reduction was the most common surgery (n = 24/48, 50%). Most patients had uneventful recovery (n = 40/54, 74.07%).

CONCLUSION

Gigantomastia is a difficult condition, in terms of its management. We have found that surgery is the gold-standard among all the cases reported; while Bromocriptine was the most commonly administered medical therapy. This systematic review provides a guideline for plastic surgeons to better facilitate their care of these patients.

LEVEL OF EVIDENCE III

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