Ann Pediatr Endocrinol Metab.  2014 Mar;19(1):45-48. 10.6065/apem.2014.19.1.45.

Giant juvenile fibroadenoma of the breast: a case report and brief literature review

Affiliations
  • 1Department of Pediatrics, Korea Institute of Radiological & Medical Sciences, Korea Cancer Center Hospital, Seoul, Korea. limjs@kcch.re.kr
  • 2Department of Surgery, Korea Institute of Radiological & Medical Sciences, Korea Cancer Center Hospital, Seoul, Korea.
  • 3Department of Pathology, Korea Institute of Radiological & Medical Sciences, Korea Cancer Center Hospital, Seoul, Korea.

Abstract

A girl (age, 12 years 11 months) consulted the pediatric endocrinology clinic because of a rapidly growing right breast mass over 13 cm observed during the preceding 3 months. A surgical excision was performed, and the mass was diagnosed as a giant juvenile fibroadenoma. Giant juvenile fibroadenomas are rare, usually occurring between 10 and 18 years of age, and characterized by massive and rapid enlargement of an encapsulated mass. The etiology is believed to be an end-organ hypersensitivity to normal levels of estrogen. We report a case of giant juvenile fibroadenoma and present a review of the diagnostic workup and management of a large breast tumor during adolescence.

Keyword

Juvenile gigantomastia; Fibroadenoma; Breast; Adolescent

MeSH Terms

Adolescent
Breast Neoplasms
Breast*
Endocrinology
Estrogens
Female
Fibroadenoma*
Humans
Hypersensitivity
Estrogens

Figure

  • Fig. 1 Gross appearance of the right breast. The overlying skin has a shiny, tense appearance with vein engorgement.

  • Fig. 2 An ultrasonogram showing a well capsulated giant homogeneous isoechoic mass occupying entire right breast.

  • Fig. 3 The tumor is covered with a capsule and is elastic hard. The cut surface is solid and has a yellowish white tan color.

  • Fig. 4 The tumor shows pericanalicular pattern growth, uniformly increased stromal cellularity, and epithelial proliferation (H&E, ×40).


Reference

1. Boothroyd A, Carty H. Breast masses in childhood and adolescence: a presentation of 17 cases and a review of the literature. Pediatr Radiol. 1994; 24:81–84. PMID: 8078727.
2. Neinstein LS. Breast disease in adolescents and young women. Pediatr Clin North Am. 1999; 46:607–629. PMID: 10384810.
Article
3. Fallat ME, Ignacio RC Jr. Breast disorders in children and adolescents. J Pediatr Adolesc Gynecol. 2008; 21:311–316. PMID: 19064223.
Article
4. Park CA, David LR, Argenta LC. Breast asymmetry: presentation of a giant fibroadenoma. Breast J. 2006; 12:451–461. PMID: 16958965.
Article
5. Ugburo AO, Olajide TO, Fadeyibi IO, Mofikoya BO, Lawal AO, Osinowo AO. Differential diagnosis and management of giant fibroadenoma: comparing excision with reduction mammoplasty incision and excision with inframammary incision. J Plast Surg Hand Surg. 2012; 46:354–358. PMID: 22998148.
Article
6. Lee CJ, Kim YJ, Seo YT, Pak SJ, Lee SI. Treatment of multiple bilateral juvenile fibroadenomas in a teenage breast by central pedicle breast reduction, with vertical and short horizontal scar: case report. Aesthetic Plast Surg. 2004; 28:228–230. PMID: 15599536.
Article
7. Nikumbh DB, Desai SR, Madan PS, Patil NJ, Wader JV. Bilateral giant juvenile fibroadenomas of breasts:a case report. Patholog Res Int. 2011; 2011:482046. PMID: 21660274.
Article
8. Tochika N, Ogawa Y, Kumon M, Araki K, Sugimoto T, Ohtsuki Y, et al. Rapid growing fibroadenoma in an adolescent. Breast Cancer. 1998; 5:321–324. PMID: 18841338.
Article
9. Anavi BL, Mishev GG, Ivanov GP. Giant fibroadenoma of the breasts. Folia Med (Plovdiv). 2002; 44:50–52. PMID: 12751688.
10. Musio F, Mozingo D, Otchy DP. Multiple, gi ant fibroadenoma. Am Surg. 1991; 57:438–441. PMID: 1647714.
11. Rao BR, Meyer JS, Fry CG. Most cystosarcoma phyllodes and fibroadenomas have progesterone receptor but lack estrogen receptor: stromal localization of progesterone receptor. Cancer. 1981; 47:2016–2021. PMID: 6261932.
Article
12. Juan R. Breast. In : Juan R, editor. Rosai and Ackerman's surgical pathology. 9th ed. Philadelphia: Mosby.
13. Vade A, Lafita VS, Ward KA, Lim-Dunham JE, Bova D. Role of breast sonography in imaging of adolescents with palpable solid breast masses. AJR Am J Roentgenol. 2008; 191:659–663. PMID: 18716091.
Article
14. Neinstein LS, Atkinson J, Diament M. Prevalence and longitudinal study of breast masses in adolescents. J Adolesc Health. 1993; 14:277–281. PMID: 8347638.
Article
15. Jayasinghe Y, Simmons PS. Fibroadenomas in adolescence. Curr Opin Obstet Gynecol. 2009; 21:402–406. PMID: 19606032.
Article
16. Ozzello L, Gump FE. The management of patients with carcinomas in fibroadenomatous tumors of the breast. Surg Gynecol Obstet. 1985; 160:99–104. PMID: 2982218.
17. Grady I, Gorsuch H, Wilburn-Bailey S. Long-term outcome of benign fibroadenomas treated by ultrasound-guided percutaneous excision. Breast J. 2008; 14:275–278. PMID: 18397185.
Article
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