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Affiliation(s)
- Saad Benali
- Department of Gynecology and Obstetrics, Military Hospital of Instructions Mohamed V of Rabat, Rabat, Morocco
| | - Jaouad Kouach
- Department of Gynecology and Obstetrics, Military Hospital of Instructions Mohamed V of Rabat, Rabat, Morocco
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Qin F, Si L, Zhang H, Zhang M, Zeng A, Long F, Yu N, Liu Z, Wang X. Management of gestational gigantomastia with breast reconstruction after mastectomy: case report and literature review. J Int Med Res 2021; 48:300060520920463. [PMID: 32529879 PMCID: PMC7294380 DOI: 10.1177/0300060520920463] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Gestational gigantomastia (GGM) is a rare complication of pregnancy. The etiology of GGM is yet to be fully established. Treatment methods for GGM include medical therapy and surgery. If medical treatment is unsuccessful, surgery may be required. Currently available surgical interventions are either breast reduction or mastectomy with delayed reconstruction. We report a case of a 25-year-old woman (G1P1) who presented with massive enlargement of both breasts during puerperium. Because of the limited effect of medical therapy, surgical intervention was considered to be the first choice. Bilateral mastectomies with grafting of the nipple–areola complex and immediate bilateral tissue expander implantation were performed. Reconstruction was fully completed 8 months after the initial procedure by replacing tissue expanders with definitive implants. Despite being a benign condition, GGM can turn into a serious problem. GGM can be successfully reconstructed by mastectomy with delayed reconstruction and grafting of the nipple–areola complex.
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Affiliation(s)
- Feng Qin
- Department of Plastic Surgery, Peking Union Medical College Hospital, Peking Union Medical College, Beijing, China
| | - Loubin Si
- Department of Plastic Surgery, Peking Union Medical College Hospital, Peking Union Medical College, Beijing, China
| | - Hailin Zhang
- Department of Plastic Surgery, Peking Union Medical College Hospital, Peking Union Medical College, Beijing, China
| | - Mingzi Zhang
- Department of Plastic Surgery, Peking Union Medical College Hospital, Peking Union Medical College, Beijing, China
| | - Ang Zeng
- Department of Plastic Surgery, Peking Union Medical College Hospital, Peking Union Medical College, Beijing, China
| | - Fei Long
- Department of Plastic Surgery, Peking Union Medical College Hospital, Peking Union Medical College, Beijing, China
| | - Nanze Yu
- Department of Plastic Surgery, Peking Union Medical College Hospital, Peking Union Medical College, Beijing, China
| | - Zhifei Liu
- Department of Plastic Surgery, Peking Union Medical College Hospital, Peking Union Medical College, Beijing, China
| | - Xiaojun Wang
- Department of Plastic Surgery, Peking Union Medical College Hospital, Peking Union Medical College, Beijing, China
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Mahabbat N, Abdulla A, Alsufayan F, Alharbi A, Rafique A, Alqahtani M, Hashem F. Gestational gigantomastia on a Saudi woman: A case report on surgical removal and reconstruction and management of complications, KFSH&RC. Int J Surg Case Rep 2020; 77:157-160. [PMID: 33166811 PMCID: PMC7653081 DOI: 10.1016/j.ijscr.2020.10.080] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 10/15/2020] [Accepted: 10/17/2020] [Indexed: 12/27/2022] Open
Abstract
INTRODUCTION Gestational gigantomastia (GG) is a rare condition manifesting as a fast and excessive growth of the breasts in pregnant women. Its etiology is still unclear, with theories ranging from hormonal imbalances, unregulated immune response, to hypersensitivity. Medical interventions are mainly surgical in nature, though some pharmacological medications are of debatable efficacy. CASE PRESENTATION A 33-year old Saudi gravida 3 para 2 presents continuous breast enlargement since the start of her pregnancy. She complains of skin ulcerations and discharge which was initially treated conservatively with topical antibiotics. Days after she came back with worsening GG symptoms, and was admitted for bilateral skin sparing mastectomy and reconstruction, and successfully recovered. The patient came back with problems concerning the surgical implant and wound infection. Emergency operation was performed for implant removal and wound treatment. Labor induction was performed by the OB-GYN on her 39 week. The patient opted for autogenous reconstruction by bilateral latissimus dorsi flap months after delivery. After treatment of minor surgical complications, the patient successfully recovered. DISCUSSION Surgery is one of the most effective interventions for GG. Total mastectomy is preferred due to lesser risk of recurrence in subsequent pregnancies. Reduction mammoplasty offers the breastfeeding option if conducted before the delivery, but poses higher risk of recurrence in future pregnancies. CONCLUSION The patient's gestational gigantomastia condition was complicated by several ulcerations and infections. Surgery was conducted alongside antibiotic treatment. This report also highlights the importance of follow ups in managing complications.
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Affiliation(s)
- Nehal Mahabbat
- Plastic and Reconstructive Surgery Section, Surgery Department, King Faisal Specialist Hospital and Research Centre, Saudi Arabia.
| | - Asma Abdulla
- Plastic and Reconstructive Surgery Section, Surgery Department, Security Forces Hospital, Saudi Arabia.
| | - Fares Alsufayan
- Plastic and Reconstructive Surgery Section, Surgery Department, Prince Mohammed Bin Abdulaziz Hospital, Saudi Arabia.
| | - Ahmed Alharbi
- Plastic and Reconstructive Surgery Section, Surgery Department, King Khalid University Hospital, Saudi Arabia.
| | - Atif Rafique
- Section of Plastic Surgery, Department of Surgery, King Faisal Specialist Hospital and Research Centre, Saudi Arabia.
| | - Moraya Alqahtani
- Consultant Plastic and Reconstructive Surgery, Surgery Department, King Faisal Specialist Hospital and Research Centre, Saudi Arabia.
| | - Foad Hashem
- Consultant Plastic and Reconstructive Surgery, Surgery Department, King Faisal Specialist Hospital and Research Centre, Saudi Arabia.
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Athamnah MN, Al-Share MS, Hajjaj EM, Athamneh LN, Abuelaish OM. Axillary enlargement in gestational gigantomastia, an uncommon presentation of a rare disease. A case report. Int J Surg Case Rep 2020; 71:155-158. [PMID: 32454451 PMCID: PMC7251487 DOI: 10.1016/j.ijscr.2020.05.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 05/04/2020] [Accepted: 05/04/2020] [Indexed: 11/19/2022] Open
Abstract
Gestational gigantomastia presents in early pregnancy as huge continuous breast size enlargement. Axillary involvement is not mentioned in medical literature before. Conservative management of Gestational gigantomastia is a valid option depending on patient condition and tolerance.
Background Gestational gigantomastia presents in pregnancy as a rapid and excessive enlargement of the breast reducing the quality of life and causing psychological and physical impairment. Huge axillary enlargement due to Gestational gigantomastia is not mentioned in the literature before. Best treatment remains unclear as conservative and medical management are options beside the more aggressive surgical treatment. Case presentation This is a special case of Gestational gigantomastia presented by huge axillary and breast enlargement in a 34-year-old female. Treated successfully in a conservative manner, a near complete spontaneous resolution happened two months post-delivery. Conclusion Axillary involvement is not mentioned in the limited literature discussing the rare disease of gestational gigantomastia. Not only breast but also axillary area can be involved and enlarge due to this disease. Conservative non-operative management was successful.
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Affiliation(s)
- Mohammad Naser Athamnah
- Jordan Medical Council, Jordan; San Gerardo Hospital, Milano, Italy; Jordan Ministry of Health, Jordan.
| | | | | | - Liqa N Athamneh
- Translational Biology Medicine and Health - Virginia Tech, USA
| | - Omar M Abuelaish
- Jordan Medical Council, Jordan; Jordan Royal Medical Services, Jordan
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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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Bukhari SS, Manan H, Khan MM, Raza SS. Resolution Of Gestational Gigantomastia With Termination Of Pregnancy. J Ayub Med Coll Abbottabad 2018; 30:298-300. [PMID: 29938441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Less than 100 cases of gestational gigantomastia have been described in literature. The aetiology and risk factors are not well-established. Various treatments have been used with some consensus. We present the case of a 47-year-old female who presented to us with bilateral gigantomastia in her 16th week of gestation. She had massively enlarged breasts which were very painful. Relevant laboratory investigations were normal. An incisional biopsy done prior to, and two trucut samples at presentation to us, showed normal breast tissue proliferation. In the absence of adequate pain control, it was decided to electively terminate the pregnancy and give a trial of tamoxifen. She made a rapid recovery following termination without requiring the use of tamoxifen.
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Affiliation(s)
| | - Haris Manan
- Department of Surgery, Khyber Teaching Hospital, Peshawar, Pakistan
| | - Mah Muneer Khan
- Department of Surgery, Khyber Teaching Hospital, Peshawar, Pakistan
| | - Syed Shahmeer Raza
- Department of Surgery, Hayatabad Medical Complex, Hayatabad-Peshawar, Pakistan
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Traoré B, Kamate B, Conde M, Keita AM, Kourouma T, Dem A. An exceptional case of bilateral gestational gigantomastia with multiple breast lumps. Pan Afr Med J 2015; 20:309. [PMID: 26161232 PMCID: PMC4489944 DOI: 10.11604/pamj.2015.20.309.6544] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2015] [Accepted: 03/26/2015] [Indexed: 11/24/2022] Open
Abstract
Bilateral gigantomastia is a rare condition, often associated with pregnancy that is characterized by a diffuse enlargement of both breasts. Here we present a case of a late 20s woman in her seven months pregnancy with a bilateral gestational gigantomastia associated with multiple breast lumps. Histological analysis revealed a fibroadenoma. Her prolactin level after caesarean delivery was found particularly high. A significant decrease in breast size was achieved with bromocriptine treatment in conjunction with a bilateral lumpectomy. This case report highlights the diversity of gigantomastia and emphasizes the importance of a tailored, multidisciplinary approach to the diagnosis and treatment of this condition.
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Affiliation(s)
- Bangaly Traoré
- Unit of Surgical Oncology, Donka University Hospital Centre, Conakry, Guinea
| | | | - Mamoudou Conde
- Unit of Surgical Oncology, Donka University Hospital Centre, Conakry, Guinea
| | | | - Tidiane Kourouma
- Unit of Surgical Oncology, Donka University Hospital Centre, Conakry, Guinea
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Nail-Barthelemy R, Burin des Roziers B, Daoud G, Cartier S. [Breast reconstruction for gigantomastia complicating pregnancy. A case report]. ANN CHIR PLAST ESTH 2014; 60:330-5. [PMID: 25236975 DOI: 10.1016/j.anplas.2014.08.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2014] [Accepted: 08/24/2014] [Indexed: 10/24/2022]
Abstract
The authors report a very rare case of gestational gigantomastia and the pregnancy could be carried out in term. The patient has been operated of bilateral mastectomy with immediate reconstruction. Surgery is the only radical treatment. Mastectomy with secondary reconstruction is reserved to cases where the intervention must be fast. Mastectomy with immediate reconstruction is the advised intervention if there is a later desire of pregnancy. Mammary reduction is more aesthetic, and allows only one intervention, but exposes to an important risk of recurrence and is not recommended if there is a later desire of pregnancy.
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Affiliation(s)
- R Nail-Barthelemy
- Service de chirurgie plastique reconstructrice et esthétique, chirurgie maxillo-faciale et stomatologie, centre hospitalier de Gonesse, 25, rue Pierre-de-Theilley, BP 30071, 95500 Gonesse cedex, France.
| | - B Burin des Roziers
- Service de chirurgie plastique reconstructrice et esthétique, chirurgie maxillo-faciale et stomatologie, centre hospitalier de Gonesse, 25, rue Pierre-de-Theilley, BP 30071, 95500 Gonesse cedex, France
| | - G Daoud
- Service de chirurgie plastique reconstructrice et esthétique, chirurgie maxillo-faciale et stomatologie, centre hospitalier de Gonesse, 25, rue Pierre-de-Theilley, BP 30071, 95500 Gonesse cedex, France
| | - S Cartier
- Service de chirurgie plastique reconstructrice et esthétique, chirurgie maxillo-faciale et stomatologie, centre hospitalier de Gonesse, 25, rue Pierre-de-Theilley, BP 30071, 95500 Gonesse cedex, France
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