Skip to main content
Erschienen in: Archives of Gynecology and Obstetrics 1/2012

01.01.2012 | Gynecologic Oncology

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

verfasst von: Thorsten Heilmann, Ivo Leuschner, Felix Hilpert, Carolin Kümper, Alexander Strauss, Christoph Mundhenke, Walter Jonat, Maret Bauer

Erschienen in: Archives of Gynecology and Obstetrics | Ausgabe 1/2012

Einloggen, um Zugang zu erhalten

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.
Literatur
1.
Zurück zum Zitat Arca MJ, Caniano DA (2004) Breast disorders in the adolescent patient. Adolesc Med Clin 15(3):473–485PubMedCrossRef Arca MJ, Caniano DA (2004) Breast disorders in the adolescent patient. Adolesc Med Clin 15(3):473–485PubMedCrossRef
2.
Zurück zum Zitat Hanna RM, Ashebu SD (2002) Giant fibroadenoma of the breast in an Arab population. Australias Radiol 46(3):252–256CrossRef Hanna RM, Ashebu SD (2002) Giant fibroadenoma of the breast in an Arab population. Australias Radiol 46(3):252–256CrossRef
3.
Zurück zum Zitat Scott-Conner CE, Schorr SJ (1995) The diagnosis and management of breast problems during pregnancy and lactation. Am J Surg 170(4):401–405PubMedCrossRef Scott-Conner CE, Schorr SJ (1995) The diagnosis and management of breast problems during pregnancy and lactation. Am J Surg 170(4):401–405PubMedCrossRef
4.
Zurück zum Zitat Kuijper A, Mommers EC, van der Wall E, van Diest PJ (2001) Histopathology of fibroadenoma of the breast. Am J Clin Pathol 115(5):736–742PubMedCrossRef Kuijper A, Mommers EC, van der Wall E, van Diest PJ (2001) Histopathology of fibroadenoma of the breast. Am J Clin Pathol 115(5):736–742PubMedCrossRef
5.
Zurück zum Zitat Tea MK, Asseryanis E, Kroiss R, Kubista E, Wagner T (2009) Surgical breast lesions in adolescent females. Pediatr Surg Int 25(1):73–75PubMedCrossRef Tea MK, Asseryanis E, Kroiss R, Kubista E, Wagner T (2009) Surgical breast lesions in adolescent females. Pediatr Surg Int 25(1):73–75PubMedCrossRef
6.
Zurück zum Zitat Belkacémi Y, Bousquet G, Marsiglia H, Ray-Coquard I, Magné N, Malard Y, Lacroix M, Gutierrez C, Senkus E, Christie D, Drumea K, Lagneau E, Kadish SP, Scandolaro L, Azria D, Ozsahin M (2008) Phyllodes tumor of the breast. Int J Radiat Oncol Biol Phys 70(2):492–500PubMedCrossRef Belkacémi Y, Bousquet G, Marsiglia H, Ray-Coquard I, Magné N, Malard Y, Lacroix M, Gutierrez C, Senkus E, Christie D, Drumea K, Lagneau E, Kadish SP, Scandolaro L, Azria D, Ozsahin M (2008) Phyllodes tumor of the breast. Int J Radiat Oncol Biol Phys 70(2):492–500PubMedCrossRef
8.
Zurück zum Zitat Wurdinger S, Herzog AB, Fischer DR, Marx C, Raabe G, Schneider A, Kaiser WA (2005) Differentiation of phyllodes breast tumors from fibroadenomas on MRI. AJR Am J Roentgenol 185(5):1317–1321PubMedCrossRef Wurdinger S, Herzog AB, Fischer DR, Marx C, Raabe G, Schneider A, Kaiser WA (2005) Differentiation of phyllodes breast tumors from fibroadenomas on MRI. AJR Am J Roentgenol 185(5):1317–1321PubMedCrossRef
9.
Zurück zum Zitat Krishnamurthy S, Ashfaq R, Shin HJ, Sneige N (2000) Distinction of phyllodes tumor from fibroadenoma: a reappraisal of an old problem. Cancer 90(6):342–349PubMedCrossRef Krishnamurthy S, Ashfaq R, Shin HJ, Sneige N (2000) Distinction of phyllodes tumor from fibroadenoma: a reappraisal of an old problem. Cancer 90(6):342–349PubMedCrossRef
10.
Zurück zum Zitat Chua CL, Thomas A, Ng BK (1989) Cystosarcoma phyllodes: a review of surgical options. Surgery 105(2 pt 1):141–147 Chua CL, Thomas A, Ng BK (1989) Cystosarcoma phyllodes: a review of surgical options. Surgery 105(2 pt 1):141–147
11.
Zurück zum Zitat Baxi M, Agarwal A, Mishra A, Agarwal G, Mishra SK (2000) Multiple bilateral giant juvenile fibroadenomas of breast. Eur J Surg 166(10):828–830PubMedCrossRef Baxi M, Agarwal A, Mishra A, Agarwal G, Mishra SK (2000) Multiple bilateral giant juvenile fibroadenomas of breast. Eur J Surg 166(10):828–830PubMedCrossRef
12.
Zurück zum Zitat Muttarak M, Chaiwun B (2004) Imaging of giant breast masses with pathological correlation. Singapore Med J 45(3):132–139PubMed Muttarak M, Chaiwun B (2004) Imaging of giant breast masses with pathological correlation. Singapore Med J 45(3):132–139PubMed
13.
Zurück zum Zitat Raganoonan C, Fairbairn JK, Williams S, Hughes LE (1987) Giant breast tumours of adolescence. Aust N Z J Surg 57(4):243–247PubMedCrossRef Raganoonan C, Fairbairn JK, Williams S, Hughes LE (1987) Giant breast tumours of adolescence. Aust N Z J Surg 57(4):243–247PubMedCrossRef
14.
Zurück zum Zitat Greenberg R, Skornick Y, Kaplan O (1998) Management of breast fibroadenomas. J Gen Intern Med 13(9):640–645PubMedCrossRef Greenberg R, Skornick Y, Kaplan O (1998) Management of breast fibroadenomas. J Gen Intern Med 13(9):640–645PubMedCrossRef
15.
Zurück zum Zitat Carty NJ, Carter C, Rubin C, Ravichandran D, Royle GT, Taylor I (1995) Management of fibroadenoma of the breast. Ann R Coll Surg Engl 77(2):127–130PubMed Carty NJ, Carter C, Rubin C, Ravichandran D, Royle GT, Taylor I (1995) Management of fibroadenoma of the breast. Ann R Coll Surg Engl 77(2):127–130PubMed
16.
Zurück zum Zitat Melnick DM, Wahl WL, Dalton VK (2004) Management of general surgical problems in the pregnant patient. Am J Surg 187(2):170–180PubMedCrossRef Melnick DM, Wahl WL, Dalton VK (2004) Management of general surgical problems in the pregnant patient. Am J Surg 187(2):170–180PubMedCrossRef
17.
Zurück zum Zitat Rosen MA (1999) Management of anesthesia for the pregnant surgical patient. Anesthesiology 91(4):1159–1163PubMedCrossRef Rosen MA (1999) Management of anesthesia for the pregnant surgical patient. Anesthesiology 91(4):1159–1163PubMedCrossRef
18.
Zurück zum Zitat Immer-Bansi A, Immer FF, Henle S, Spörri S, Petersen-Felix S (2001) Unnecessary emergency caesarean section due to silent CTG during anaesthesia? Br J Anaesth 87(5):791–793PubMedCrossRef Immer-Bansi A, Immer FF, Henle S, Spörri S, Petersen-Felix S (2001) Unnecessary emergency caesarean section due to silent CTG during anaesthesia? Br J Anaesth 87(5):791–793PubMedCrossRef
19.
Zurück zum Zitat Martin F, Viviand X, Desbriere R, Boubli L, Martin C (2004) Do we have to monitor foetal heart rate during general anesthesia? Ann Fr Anesth Reanim 23(12):1179–1181PubMedCrossRef Martin F, Viviand X, Desbriere R, Boubli L, Martin C (2004) Do we have to monitor foetal heart rate during general anesthesia? Ann Fr Anesth Reanim 23(12):1179–1181PubMedCrossRef
Metadaten
Titel
Diagnosis and management of an unilateral giant fibroadenoma of the breast in pregnancy
verfasst von
Thorsten Heilmann
Ivo Leuschner
Felix Hilpert
Carolin Kümper
Alexander Strauss
Christoph Mundhenke
Walter Jonat
Maret Bauer
Publikationsdatum
01.01.2012
Verlag
Springer-Verlag
Erschienen in
Archives of Gynecology and Obstetrics / Ausgabe 1/2012
Print ISSN: 0932-0067
Elektronische ISSN: 1432-0711
DOI
https://doi.org/10.1007/s00404-011-1923-9

Weitere Artikel der Ausgabe 1/2012

Archives of Gynecology and Obstetrics 1/2012 Zur Ausgabe

Update Gynäkologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert – ganz bequem per eMail.