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Eleftheriades A, Tsarna E, Toutoudaki K, Paschalidou E, Christopoulos N, Georgopoulos I, Mitropoulou G, Christopoulos P. Giant Juvenile Fibroadenoma: Case Report and Review of the Literature. J Clin Med 2023; 12:jcm12051855. [PMID: 36902642 PMCID: PMC10003210 DOI: 10.3390/jcm12051855] [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: 01/06/2023] [Revised: 02/21/2023] [Accepted: 02/23/2023] [Indexed: 03/02/2023] Open
Abstract
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.
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Affiliation(s)
- Anna Eleftheriades
- Postgraduate Programme “Maternal Fetal Medicine”, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Ermioni Tsarna
- Second Department of Obstetrics and Gynecology, “Aretaieion” Hospital, Faculty of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | - Konstantina Toutoudaki
- Second Department of Obstetrics and Gynecology, “Aretaieion” Hospital, Faculty of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | - Eleni Paschalidou
- Second Department of Obstetrics and Gynecology, “Aretaieion” Hospital, Faculty of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | | | - Ioannis Georgopoulos
- Department of Pediatric Surgery, “Agia Sofia” Children’s Hospital, 11527 Athens, Greece
| | - Georgia Mitropoulou
- Department of Pathology, “Agia Sofia” Children’s Hospital, 11527 Athens, Greece
| | - Panagiotis Christopoulos
- Second Department of Obstetrics and Gynecology, “Aretaieion” Hospital, Faculty of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece
- Correspondence:
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Radiologic and Pathologic Correlation for Benign Breast Processes. CURRENT BREAST CANCER REPORTS 2021. [DOI: 10.1007/s12609-021-00438-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Yin Lee JP, Thomas AJ, Lum SK, Shamsudin NH, Hii LW, Mai CW, Wong SF, Leong CO. Gene expression profiling of giant fibroadenomas of the breast. Surg Oncol 2021; 37:101536. [PMID: 33677364 DOI: 10.1016/j.suronc.2021.101536] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 10/24/2020] [Accepted: 02/24/2021] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Fibroadenomas of the breast present as two phenotypic variants. The usual variety is 5 cm or less in diameter and there is another large variant called giant fibroadenoma which is greater than 5 cm in diameter. Despite of its large size, it is not malignant. The aim of our study is to determine whether this large variant is different from the usual fibroadenoma in terms of its biological pathways and biomarkers. METHODS mRNA was extracted from 44 fibroadenomas and 36 giant fibroadenomas, and transcriptomic profiling was performed to identify up- and down-regulated genes in the giant fibroadenomas as compared to the fibroadenomas. RESULTS A total of 40 genes were significantly up-regulated and 18 genes were significantly down-regulated in the giant fibroadenomas as compared to the fibroadenomas of the breast. The top 5 up-regulated genes were FN1, IL3, CDC6, FGF8 and BMP8A. The top 5 down-regulated genes were TNR, CDKN2A, COL5A1, THBS4 and BMPR1B. The differentially expressed genes (DEGs) were found to be associated with 5 major canonical pathways involved in cell growth (PI3K-AKT, cell cycle regulation, WNT, and RAS signalling) and immune response (JAK-STAT signalling). Further analyses using 3 supervised learning algorithms identified an 8-gene signature (FN1, CDC6, IL23A, CCNA1, MCM4, FLT1, FGF22 and COL5A1) that could distinguish giant fibroadenomas from fibroadenomas with high predictive accuracy. CONCLUSION Our findings demonstrated that the giant fibroadenomas are biologically distinct to fibroadenomas of the breast with overexpression of genes involved in the regulation of cell growth and immune response.
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Affiliation(s)
- June Pui Yin Lee
- School of Medicine, International Medical University, Kuala Lumpur, Malaysia
| | | | - Siew Kheong Lum
- School of Medicine, International Medical University, Kuala Lumpur, Malaysia.
| | | | - Ling-Wei Hii
- Center for Cancer and Stem Cell Research, Institute for Research, Development and Innovation (IRDI), International Medical University, Kuala Lumpur, Malaysia; School of Pharmacy, International Medical University, Kuala Lumpur, Malaysia; School of Postgraduate Studies, International Medical University, Kuala Lumpur, Malaysia
| | - Chun-Wai Mai
- Center for Cancer and Stem Cell Research, Institute for Research, Development and Innovation (IRDI), International Medical University, Kuala Lumpur, Malaysia; School of Pharmacy, International Medical University, Kuala Lumpur, Malaysia
| | - Shew-Fung Wong
- School of Medicine, International Medical University, Kuala Lumpur, Malaysia; Center for Environmental and Population Health, Institute for Research, Development and Innovation (IRDI), International Medical University, Kuala Lumpur, Malaysia
| | - Chee-Onn Leong
- Center for Cancer and Stem Cell Research, Institute for Research, Development and Innovation (IRDI), International Medical University, Kuala Lumpur, Malaysia; School of Pharmacy, International Medical University, Kuala Lumpur, Malaysia.
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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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Md Nasir ND, Ng CCY, Rajasegaran V, Wong SF, Liu W, Ng GXP, Lee JY, Guan P, Lim JQ, Thike AA, Koh VCY, Loke BN, Chang KTE, Gudi MA, Lian DWQ, Madhukumar P, Tan BKT, Tan VKM, Wong CY, Yong WS, Ho GH, Ong KW, Tan P, Teh BT, Tan PH, Rahman NA, Nahar Begum SMK, Cheah PL, Chen CJ, Dela Fuente E, Han A, Harada O, Kanomata N, Lee CS, Han Lee JY, Kamal M, Nishimura R, Ohi Y, Sawyer EJ, Teoh KH, Tsang AKH, Tsang JY, Tse GMK, Yamaguchi R. Genomic characterisation of breast fibroepithelial lesions in an international cohort. J Pathol 2019; 249:447-460. [DOI: 10.1002/path.5333] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2019] [Revised: 07/11/2019] [Accepted: 08/01/2019] [Indexed: 12/31/2022]
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Corredor Andrés B, Márquez Rivera M, Lobo Bailón F, González Meli B, Azorín Cuadrillero D, Muñoz Calvo MT, Argente J. Giant breast fibroadenomas in adolescents: Diagnostic and therapeutic procedures. An Pediatr (Barc) 2018. [DOI: 10.1016/j.anpede.2018.01.013] [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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Corredor Andrés B, Márquez Rivera M, Lobo Bailón F, González Meli B, Azorín Cuadrillero D, Muñoz Calvo MT, Argente J. [Giant breast fibroadenomas in adolescents: Diagnostic and therapeutic procedures]. An Pediatr (Barc) 2018; 89:383-385. [PMID: 29802049 DOI: 10.1016/j.anpedi.2018.01.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Revised: 01/03/2018] [Accepted: 01/06/2018] [Indexed: 11/26/2022] Open
Affiliation(s)
- Beatriz Corredor Andrés
- Servicio de Pediatría, Hospital Infantil Universitario Niño Jesús, Madrid, España; Servicio de Endocrinología, Hospital Infantil Universitario Niño Jesús, Madrid, España
| | - María Márquez Rivera
- Servicio de Pediatría, Hospital Infantil Universitario Niño Jesús, Madrid, España; Servicio de Endocrinología, Hospital Infantil Universitario Niño Jesús, Madrid, España
| | - Fernando Lobo Bailón
- Sección de Cirugía Plástica, Hospital Infantil Universitario Niño Jesús, Madrid, España
| | - Beatriz González Meli
- Sección de Cirugía Plástica, Hospital Infantil Universitario Niño Jesús, Madrid, España
| | | | - María Teresa Muñoz Calvo
- Servicio de Pediatría, Hospital Infantil Universitario Niño Jesús, Madrid, España; Servicio de Endocrinología, Hospital Infantil Universitario Niño Jesús, Madrid, España; Departamento de Pediatría, Universidad Autónoma de Madrid, Madrid, España; CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, España.
| | - Jesús Argente
- Servicio de Pediatría, Hospital Infantil Universitario Niño Jesús, Madrid, España; Servicio de Endocrinología, Hospital Infantil Universitario Niño Jesús, Madrid, España; Departamento de Pediatría, Universidad Autónoma de Madrid, Madrid, España; CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, España; IMDEA Instituto de Alimentación, CEI UAM + CSIC, Madrid, España
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