Bilateral Giant Juvenile Fibroadenoma of Breast

Abstract

Fibroadenomas are benign lesions of breast commonly found in young age group. These focal tumours contain both mesenchymal and glandular tissue. Giant juvenile fibroma of breast is rare variant of fibroadenoma found usually in less than 20 years of age. They present with rapid enlargement of single or multiple, discrete, painless large nodule of breast. A 14-years-old premenarche girl presented with large bilateral breast lumps for two months. FNAC showed features of juvenile fibroadenoma. Breast conserving surgical excision of lumps was performed and histopathology confirmed the diagnosis of juvenile fibroadenoma. Giant juvenile fibroadenomas are characterised by rapid enlargement of encapsulated mass. The aetiology is unknown, although end-organ hypersensitivity to normal level of estrogen is postulated. We present a case of bilateral giant juvenile fibroadenoma for its rarity.

Giant juvenile fibroadenoma in an adolescent female: A case report

“…Radiological investigations include ultrasonography (USG) and mammography for routine imaging along with magnetic resonance imaging (MRI) in selected cases; however, the definite diagnosis is difficult to be made upon the radiology alone. On USG, fibroadenomas appear as a well‐circumscribed round or oval solid mass, with weak internal echoes in a uniform distribution and intermediate acoustic attenuation; however, the accuracy of diagnosis is around 78.8% in the case series by Smith et al, where the total sample size was 447 with age ≤25 years of age 11,12 . The use of mammograms in young females has widely been documented to be of limited value due to increased breast density, and utility is limited due to poor image quality in younger patients as well as the extremely low risk of malignancy 13,14 .…”

Giant fibroadenoma of the breast: A rare case in a mature woman

“…US is non-invasive modality and is useful in the diagnosis of lesions in breast tissue. On US, fibroadenomas appear as a well circumscribed round or oval solid mass, with weak internal echoes in a uniform distribution and intermediate acoustic attenuation [[2], [3], [4],6]. Smith et al [7], however, reported that accuracy of US in the diagnosis of fibroadenoma was only 78.8% based on the evaluation of 447 patients of ≤25 years of age.…”

Mammotome-assisted removal with minimal incision of large juvenile fibroadenoma of breast

“…[ 5 ] Unlike smaller fibroadenomas, which can be treated by other means, resection of giant juvenile fibroadenomas is required as a diagnostic and therapeutic approach. [ 6 ] Varying techniques in surgical extirpation have been described in order to optimize esthetics and minimize distortion. These include video-assisted endoscopic extirpation with and without morcellation, [ 7 ] “Swiss-roll” technique, [ 8 ] “Saw Tooth” operation, [ 9 ] circumareolar incision with T-shaped or lateral extension, [ 10 ] a sub-mammary incision, [ 11 ] endovascular embolization before operation, [ 12 ] reduction mammaplasty, and mastectomy.…”