Management and Follow-Up of a Case of Gestational Gigantomastia in a Brazilian Hospital

Abstract

Gigantomastia is a breast disorder that is associated with an exaggerated, rapid growth of the breasts, generally bilaterally. Since the pathology is rare and has seldom been described, its etiology has yet to be fully established, although there are speculations that a hormonal component may play an important role. Treatment is aimed at improving the clinical and psychological symptoms; however, the best therapeutic option varies from case to case. The present report describes a case of gestational gigantomastia seen at the Department of Obstetrics and Gynecology of the Hospital da Santa Casa de Misericórdia, Vitória, Espírito Santo, Brazil, in a primigravida in the second trimester of pregnancy. The report follows this patient from her diagnosis until the completion of treatment with a third and final surgical procedure.

Gestational Gigantomastia Complicating Pregnancy: A Case Report and Review of the Literature

“…The first case of GG was described by Palmuth in 1648 [ 3 – 5 ]. Since his initial description, approximately 100 cases have been reported in the literature [ 4 , 6 , 7 ]. The incidence of GG has been reported to be between 1 in 28,000 and 1 in 100,000 pregnancies between the years of 1935–1960 [ 2 , 6 ] and 1989–2009, respectively [ 8 – 10 ].…”

Gestational gigantomastia with fatal outcome

“…17 The histological analysis of breast tissue often reveals pregnancy-lactation changes such as glandular hyperplasia without atypia, overgrowth of connective tissue, and tissue fibrosis, with the absence of prominent inflammatory infiltrate, as in our case. 18 Although the condition is completely benign, the clinical presentation may mimic malignancy, as was initially suspected in our case. Occasionally, malignant tumors can cause massive enlargement of the breasts mimicking gigantomastia (two cases of invasive ductal carcinoma, two cases of lobular carcinoma in situ, 19 and occasional lymphomas, 20 but most of these cases are not related to pregnancy).…”

“…21 Remarkably, once GG has occurred, recurrences are likely to occur in subsequent pregnancies unless surgery is performed. 18,22 However, the management of GG is difficult in low-resource settings where many pregnant women have limited access to essential health services. In addition, the disease has more serious consequences because breastfeeding is of utmost importance in these settings.…”

Temporary banking of the nipple-areola complex in breast reconstruction following mastectomy for gigantomastia

“…The etiology of GGM is unclear, but endocrine imbalance, hyperprolactinemia, and target organ hypersensitivity have been suggested as causes [ 3 , 4 ]. The choice of treatment varies based on the severity and gestation time [ 4 ].…”