Diagnosis and management of an unilateral giant fibroadenoma of the breast in pregnancy.

ABSTRACT

BACKGROUND: Fibroadenomas represent the vast majority of breast pathologies in young women. 2-4% of the fibroadenomas exceed 5 cm in size or 500 g in weight and are called "giant fibroadenomas". Due to their excessive growth they are usually enucleated to clarify a malignant origin, to differentiate from phyllodes tumor and to prevent persisting deformities of the breast. CASE We present a case of a 17-year-old female who was pregnant in the 24th week and suffered from a giant fibroadenoma in the right breast. Besides the massive swelling no other illnesses were found. The patient was clinically asymptomatic and had noticed the tumor just 8 weeks ago. On clinical examination we found a tumor of more than 10 cm in size which fulfilled the criteria of a benign process. A prior performed biopsy and an ultrasound investigation could not definitely differentiate the mass from phyllodes tumor. Because of the rapid growth and the progressive deformation of the breast a lumpectomy was indicated and performed without complications in consideration of the gestational stage. CONCLUSION: We present a rare case of giant fibroadenoma in pregnant young women. Because of the progressive structural damage of the breast immediate surgical enucleation was indicated. Safety of the fetus was provided by perioperative monitoring. The pre-operative differentiation from phyllodes tumor is still challenging.