Giant Juvenile Fibroadenoma: Case Report and Review of the Literature

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.

Profile of Fibroadenoma Mammae Patients at MRCCC Siloam Semanggi Hospital 2019-2020

“…It is evidenced by the histological structure of FAM, similar to hyperplastic breast lobules, where the FAM responds to a hormonal stimulus [24]. This opinion is in line with the study of Matz et al, which suggested that women at the age of 15-25 years, or what is known as menarche, can have FAM lumps in their breasts due to the link between lobule sensitivity and reproductive hormones which are risk factors for FAM [39].…”

“…When women age, the FAM lump will shrink and even disappear. A decrease in the response of reproductive hormones causes it [20,2,39]. Therefore, women who suffer from FAM and are approaching menopause must be given as clear information as possible about the link between FAM and menopause so that they can review the management that will be carried out [17].…”

Giant juvenile fibroadenoma: A case report

“…It constitutes 30 to 50 % of breast masses. When it exceeds 5 cm, weighs more than 500 g, or occupies more than 4/5 of the breast, it is considered as giant [ 3 ]. This form is rare and constitute 0.5 % - 4 % of all fibroadenomas cases.…”

“…In its giant form, this mass tends to deform the breast, causing aesthetic discomfort [ 1 , 4 ]. Despite the rapid evolution of the mass, the general condition is preserved, and general symptoms are absent [ 3 ]. In our case, the mass had rapidly increased in size within two months, causing significant discomfort and fear for the patient.…”

Bilateral gigantomastia due to benign breast tumors: a case series and brief review focusing on bilateral diffuse pseudoangiomatous stromal hyperplasia

“…The remaining breast tissue gradually fills the empty space after tumor excision, eliminating the need for further reconstructive procedures. However, large juvenile fibroadenoma lesions can compress the surrounding healthy breast tissue, complicating accurate assessment of the unaffected parenchyma [12,13].…”