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Dafaalla H, Khougali HS, Malassi Y. Bilateral complex lactating adenosis: Clinical presentation and management in Sudan. Clin Case Rep 2021; 9:e05213. [PMID: 34938564 PMCID: PMC8667293 DOI: 10.1002/ccr3.5213] [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] [Received: 07/10/2021] [Revised: 10/26/2021] [Accepted: 11/09/2021] [Indexed: 11/25/2022] Open
Abstract
Lactating adenosis is a benign breast neoplasm usually seen during pregnancy and lactation. We present a rare case of bilateral complex benign lactating adenosis in 19-year-old female patient presented with lactating adenosis that mimics cancer growth after giving birth. Histopathology confirmed diagnosis. Simple mastectomy was the treatment of choice.
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Affiliation(s)
- Hatoun Dafaalla
- Department of General SurgeryWad‐Medani Teaching HospitalWad‐MedaniSudan
| | | | - Yussra Malassi
- Department of Research and MethodologyIbn‐Seina HospitalKhartoumSudan
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Moulaz IR, de Oliveira FSS, da Silva EC, Machado JM, Santos MCLFS. Giant lactating adenoma. AUTOPSY AND CASE REPORTS 2021; 11:e2021252. [PMID: 33968827 PMCID: PMC8087397 DOI: 10.4322/acr.2021.252] [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: 11/23/2022] Open
Abstract
Lactating adenoma is a rare benign breast lesion that most often presents as a small (up to 3 cm), solid, well-circumscribed, solitary, painless, mobile, lobulated mass. The highest incidence occurs in primiparous women (20 to 40 years old) during the third trimester of pregnancy. However, in the rare case presented herein, in addition to its giant size (more than 10 centimeters on palpation), this lactating adenoma is distinctive due to the presence of multiple nodules, poorly defined ultrasonographic margins, worrisome radiologic features, growth since early pregnancy, presence of infarction and association with chronic mastitis. From the clinical-radiologic perspective, the differential diagnoses included abscess associated with puerperal mastitis, phyllodes tumor, and galactocele. Biopsy was performed, and pathologic examination revealed the classic characteristics of lactating adenoma with multiple infarcted areas, leading to an unexpected confirmed case of giant lactating adenoma.
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Affiliation(s)
| | | | - Eveline Cristina da Silva
- Universidade Federal do Espírito Santo, Medical School, Department of Pathology, Vitória, ES, Brasil
| | - Janine Martins Machado
- Universidade Federal do Espírito Santo, Medical School, Department of Obstetrics and Gynecology, Vitória, ES, Brasil
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Breast lactating adenoma, an example of the utility of the radiological-pathological correlation. Clin Imaging 2020; 71:136-140. [PMID: 33220595 DOI: 10.1016/j.clinimag.2020.11.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 10/04/2020] [Accepted: 11/02/2020] [Indexed: 11/21/2022]
Abstract
Lactating adenomas are benign breast tumors, of which etiology, pathogenesis, and management are not yet fully evident in the literature. The primary goal of the radiological evaluation is to make the differential diagnosis with malignant conditions. We present a case of a 34-year-old pregnant woman referred to our service with a progressively increasing mass in the right breast, in whom the histopathology was consistent with a lactating adenoma.
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Phung HT, Nguyen LT, Nguyen HV, Nguyen CV, Nguyen HT. Aggressive lactating adenoma mimicking breast carcinoma: A case report. Int J Surg Case Rep 2020; 70:17-19. [PMID: 32348915 PMCID: PMC7191075 DOI: 10.1016/j.ijscr.2020.03.047] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Revised: 03/17/2020] [Accepted: 03/30/2020] [Indexed: 11/27/2022] Open
Abstract
INTRODUCTION Lactating adenoma is a rare breast tumor which is commonly found in late pregnancy or lactation period. Despite its benign nature, lactating adenoma might develop aggressively and can be misdiagnosed as breast cancer. CASE PRESENTATION We report a case of a 25-year-old female presenting with two large, ulcerative and bleeding breast masses. An open biopsy demonstrating lactating adenoma was considered discordant and surgery was performed to confirm the diagnosis. CONCLUSION Careful clinical and histological evaluations are necessary to diagnose and manage lactating adenoma.
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Affiliation(s)
- Huyen Thi Phung
- Department of Medical Oncology 6, Vietnam National Cancer Hospital, Hanoi, Viet Nam; Department of Oncology, Vietnam University of Traditional Medicine, Hanoi, Viet Nam
| | | | - Hung Van Nguyen
- Department of Oncology, Hanoi Medical University, Hanoi, Viet Nam; Department of Oncology and Palliative Care, Hanoi Medical University Hospital, Hanoi, Viet Nam
| | - Chu Van Nguyen
- Quan Su Pathology Department, Vietnam National Cancer Hospital, Hanoi, Viet Nam
| | - Hoa Thi Nguyen
- Department of Medical Oncology 6, Vietnam National Cancer Hospital, Hanoi, Viet Nam
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Benign Disorders of the Breast in Pregnancy and Lactation. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2020; 1252:43-51. [PMID: 32816261 DOI: 10.1007/978-3-030-41596-9_6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Benign cystic or solid lumps frequently occur in the breasts of young women, and consequently can also be seen during pregnancy and lactation. Simple cysts do not increase the risk of malignancy. The current management is routine follow-up. Complex cysts are thick walled or contain a mass, and should be followed by a US-guided biopsy and then treated similar to any non-gravid, non-lactating patient.Galactoceles can be detected during the last trimester of pregnancy and during or after stopping lactation. Aspiration can be done to confirm the content. Co-existence of galactocele and malignancy is extremely rare, and the key is to follow up until it resolves.Fibroadenoma is the most frequent lesion found during pregnancy and lactation. Management is usually conservative after triple assessment. Surgery is usually not recommended in pregnant and lactating women unless rapid increase in size occurs or there is discordance in the triple assessment.Lactating adenomas are sometimes interpreted as a variant of fibroadenoma . They can naturally disappear at the end of pregnancy or lactation. Management is usually conservative, and an excisional biopsy is only mandated if it is rapidly enlarging or if there is discordance in the triple assessment.Gestational gigantomastia is a rare condition consisting of diffuse severe hypertrophy of both breasts during pregnancy . Mastectomy and reconstruction may rarely be required in such cases.
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Lactating adenoma arising from a tubular adenoma in a pediatric patient. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2019. [DOI: 10.1016/j.epsc.2019.101278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Mendez MA, Jones KM, Reiman TR, Kremer HL, Ahmadiyeh N. Large painful lactating adenomas effectively treated during pregnancy with bromocriptine. Breast J 2019; 25:974-976. [PMID: 31165510 DOI: 10.1111/tbj.13380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Accepted: 02/07/2019] [Indexed: 11/29/2022]
Abstract
Lactating adenomas are painful, benign breast lesions, typically presenting during pregnancy and treated with surgery. Here we present a case of a 25-year-old pregnant woman who developed multiple, bilateral lactating adenomas and was successfully treated during her third trimester with bromocriptine alone. Bromocriptine, a dopamine agonist, may be used in pregnancy to effectively treat lactating adenomas in lieu of surgery.
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Affiliation(s)
- Marissa A Mendez
- University of Missouri Kansas City School of Medicine, Kansas City, Missouri
| | - Kimberly M Jones
- University of Missouri Kansas City School of Medicine, Kansas City, Missouri
| | - Taylor R Reiman
- University of Missouri Kansas City School of Medicine, Kansas City, Missouri
| | - Howard L Kremer
- University of Missouri Kansas City School of Medicine, Kansas City, Missouri.,Truman Medical Centers, Kansas City, Missouri
| | - Nasim Ahmadiyeh
- University of Missouri Kansas City School of Medicine, Kansas City, Missouri.,Truman Medical Centers, Kansas City, Missouri
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Elzahaby IA, Saleh S, Metwally IH, Fathi A, Atallah K. Huge lactating adenoma of the breast: Case report. Breast Dis 2018; 37:37-42. [PMID: 28269736 DOI: 10.3233/bd-160263] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Lactating adenoma is the commonest benign breast lesion seen during pregnancy and puerperium. It is commonly seen in young primigravideous women in the second or third decade during the third trimester of their pregnancy. Occasionally, lactating adenoma is large and rapidly growing and must be differentiated from malignant breast masses that could be seen during pregnancy and lactation. The diagnosis is usually established by cytological and histopathological examination. CASE PRESENTATION Here we have presented a rare case with huge lactating adenoma arising in the left breast of 38 years old Egyptian multiparous lady during lactation. Enucleation of the mass was done with good aesthetic outcome. CONCLUSION The case we have presented was unique in its huge size and in being diagnosed in a multiparous lady and furthermore it was successfully treated by enucleation without any need for reconstruction.
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Affiliation(s)
- Islam A Elzahaby
- IMRCS, Lecturer of surgical oncology, Oncology center Mansoura University Masoura, Egypt
| | - Saleh Saleh
- Assistant lecturer of surgical oncology, Oncology center Mansoura University, Mansoura, Egypt
| | - Islam H Metwally
- Assistant lecturer of surgical oncology, Oncology center Mansoura University, Mansoura, Egypt
| | - Adel Fathi
- Lecturer of surgical oncology, Oncology center Mansoura University, Mansoura, Egypt
| | - Khaled Atallah
- Assistant lecturer of surgical oncology, Oncology center Mansoura University, Mansoura, Egypt
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Murthy SS, Raju KVVN, Nair HG. Phyllodes Tumor in a Lactating Breast. Clin Med Insights Pathol 2016; 9:13-7. [PMID: 27081326 PMCID: PMC4824323 DOI: 10.4137/cpath.s38476] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2015] [Revised: 02/15/2016] [Accepted: 02/17/2015] [Indexed: 01/02/2023] Open
Abstract
Phyllodes tumor is attributed to a small fraction of primary tumors of the breast. Such tumors occur rarely in pregnancy and lactation. We report a case of a 25-year-old lactating mother presenting with a lump in the left breast. Core needle biopsy was opined as phyllodes tumor with lactational changes, and subsequent wide local excision confirmed the diagnosis of benign phyllodes tumor with lactational changes. The characteristic gross and microscopic findings of a well-circumscribed lesion with leaf-like fibroepithelial growth pattern and typical nonuniform or diffuse stromal proliferation with periductal accentuation even in the absence of mitotic figures can help clinch the diagnosis. Benign phyllodes is known for its recurrence and requires wide excision and close follow-up. It is vital to identify these lesions even on limited biopsies as therapeutic options differ. This case is presented for its rarity and the diagnostic challenge it poses in limited biopsy.
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Affiliation(s)
- Sudha S Murthy
- Senior Consultant, Department of Pathology Laboratory Medicine, Basavatarakam Indo-American Cancer Hospital and Research Institute, Hyderabad, Telangana, India
| | - K V V N Raju
- Senior Consultant, Department of Surgical Oncology, Basavatarakam Indo-American Cancer Hospital and Research Institute, Hyderabad, Telangana, India
| | - Haripreetha G Nair
- Registrar, Department of Pathology Laboratory Medicine, Basavatarakam Indo-American Cancer Hospital and Research Institute, Hyderabad, Telangana, India
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Teng CY, Diego EJ. Case report of a large lactating adenoma with rapid antepartum enlargement. Int J Surg Case Rep 2016; 20:127-9. [PMID: 26855073 PMCID: PMC4818311 DOI: 10.1016/j.ijscr.2016.01.027] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Revised: 12/24/2015] [Accepted: 01/20/2016] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION Lactating adenomas are rare benign breast tumors, most commonly found during pregnancy and lactation. They are usually slow growing and smaller than 3cm in maximal diameter. Rare cases of giant lactating adenomas and rapid postpartum enlargement have been reported, but none have shown a giant lactating adenoma with rapid antepartum enlargement or antepartum surgical management. CASE PRESENTATION A 27 year-old pregnant woman presented at 28 weeks gestation with a 5cm left breast mass that doubled to 10cm within six weeks and was increasingly tender. Histopathologic examination of a core biopsy was consistent with a lactating adenoma. The mass was excised at 31 weeks gestation with no complications. DISCUSSION Lactating adenomas are common during pregnancy and need to be distinguished from breast cancer, a commonly diagnosed malignancy in pregnancy. They can be distinguished from carcinoma and other benign tumors like fibroadenoma under histopathologic examination. Rare cases of giant lactating adenomas with rapid postpartum enlargement that were managed by postpartum excision have been reported. However, a giant lactating adenoma with rapid antepartum enlargement, managed by excision in the third trimester of pregnancy, has not been reported. CONCLUSION Excision of a large, rapidly enlarging lactating adenoma in the third trimester of pregnancy is a safe and feasible management option.
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Affiliation(s)
- Cindy Y Teng
- Department of Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States.
| | - Emilia J Diego
- Department of Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States; Division of Breast Surgical Oncology, Magee-Womens Hospital of UPMC, Pittsburgh, PA, United States.
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