Giant Fibroadenoma in a Middle-Aged Woman Requiring Mastectomy: A Case Report
Fibroadenomas are benign tumours of the breast. They are usually single, firm, rubbery masses, slow-growing and well encapsulated. Giant fibroadenomas are fibroadenomas at least 5cm in size or at least 500g in weight. The peculiarities of the index case include the massive size and weight of the breast, causing asymmetry and tissue distortion with little or no normal breast tissue on ultrasound scan. Also, such massive weight has not been reported in the literature as suggested by extensive search on databases such as Pubmed and Google Scholar. The main concern of the patient was the rapid growth over a year, with the attendant risk of malignancy. The mass was firm, lobulated, with a solitary axillary lymph node. An initial clinical diagnosis of phyllodes tumour was made. However, pre-operative Tru-cut biopsy histology suggested fibroadenoma and was confirmed using the excised post-operative specimen. Simple mastectomy with axillary lymph node excision was carried out. In conclusion, a large breast tumour may not be malignant. However, mastectomy may be a treatment option despite the benign nature of the tumour.
Santen RJ, Mansel R. Benign breast disorders. N Engl J Med 2005; 353: 275-285. doi:10.1056/NEJMra035692.
Merchant DJ. Benign breast disease. Obstet Gynecol Clin North Am 2002; 29: 1-20. doi:10.1016/s0889-8545(03)00048-2.
Jayasinghe Y, Simmons PS. Fibroadenoma in adolescence. Curr Opinion Obstet Gynecol 2009; 21: 402-406. doi:10.1097/GCO.0b013e32832fa06b.
Dolmans GH, Hoogbergen MM, van Rappard JH. Giant fibroadenoma of one breast: immediate bilateral reconstruction. J Plast Reconstr Aesthet Surg 2007; 60: 1156-1157. doi:10.1016/j.bjps.2007.01.005.
Arowolo OA, Akinkuolie AA, Adisa AO, Obonna GC, Olasode BJ. Giant fibroadenoma presenting like fungating breast cancer in a Nigerian teenager. Afr Health Sci 2013; 13: 162-165. doi:10.4314/ahs.v13i1.23.
Hanna RM, Ashebu SD. Giant fibroadenoma of the breast in an Arab population. Australas Radiol 2002; 46: 252-256. doi:10.1046/j.1440-1673.2002.01054.x.
McCague A, Davis JV. Giant fibroadenoma in a 22-year old patient: case report and literature review. Breast Dis 2010; 31: 49-52. doi:10.3233/BD-2009-0288.
Sosin M, Pulcrano M, Feldman ED, Patel KM, Nahabedian MY, Weissler MJ, et al. Giant juvenile fibroadenoma: a systematic review with diagnostic and treatment recommendations. Gland Surg 2015; 4: 312-321. doi:10.3978/j.issn.2227-684X.2015.06.04.
Achebe JU, Njeze GE, Okwesili OR. Treatment of unilateral giant fibroadenoma by breast reduction skin incision: the inverted “T” technique. Niger J Clin Pract 2014; 17: 43-46. doi:10.4103/1119-3077.122835.
Bandyopadhyay R, Nag D, Modal SK, Mukhopadhyay S, Roy S, Sinha SK. Distinction of phyllodes tumour from fibroadenoma: Cytologist’s perspective. J Cytol 2010; 27: 59-62. doi:10.4103/0970-9371.70739.
Yohe S, Yeh IT. “Missed” diagnoses of Phyllodes tumour on breast biopsy: pathological clues to its recognition. Int J Surg Pathol 2008; 2: 137-142. doi:10.1177/1066-8969.07311378.
Jacobs TW, Chen YY, Guinee Jr DG, Holden JA, Cha I, Bauermeister DE, et al. Fibroepithelial lesions with cellular stroma on breast core needle biopsy: Are there predictors of outcome on surgical excision? Am J Clin Pathol 2005; 124: 342-354. doi:10.1309/5N2C-4N5X-CBBX-W8JL.
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