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巨乳症乳房切除术后乳房重建中乳头乳晕复合体的临时保存

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

作者信息

Sowa Yoshihiro, Hori Tomoko, Kodama Takuya, Numajiri Toshiaki

机构信息

Departments of Plastic and Reconstructive Surgery, Kyoto Prefectural University of Medicine, Graduate School of Medical Sciences, Kawaramachi-Hirokoji Kajii-cho 465, Kamigyo-ku, Kyoto, 602-8566, Japan.

Departments of Plastic and Reconstructive Surgery, Kyoto Prefectural University of Medicine, Graduate School of Medical Sciences, Kawaramachi-Hirokoji Kajii-cho 465, Kamigyo-ku, Kyoto, 602-8566, Japan.

出版信息

Int J Surg Case Rep. 2021 Mar;80:105297. doi: 10.1016/j.ijscr.2020.11.047. Epub 2020 Nov 12.

Abstract

INTRODUCTION

Gigantomastia is a breast disorder characterized by exaggerated rapid growth of the breasts, generally bilaterally. In some severe cases, mastectomy is required to ensure safe delivery or control disease progression or recurrence. Subsequently, most patients want to undergo breast reconstruction, including the nipple-areola complex (NAC).

PRESENTATION OF CASE

Here, we report our experience with temporary banking of the NAC in a patient who underwent mastectomy for severe Gigantomastia. Each NAC was temporarily transplanted into the axilla as banking tissue for NAC reconstruction at a later date. Although the color of the NAC was slightly lighter after reconstruction, it mainly kept its original color and texture in addition to medical tattooing technique. At present, there has been no recurrence and the patient is fully satisfied with her appearance.

DISCUSSION

In this case, mastectomy was recommended because of an unbearable breast size that disturb a safety delivery, as well as respiratory and cardiac complications and skin ulcer control. Because the disease is not pathologically malignant, temporary preservation of NAC allows it to be safely used again for later nipple reconstruction.

CONCLUSION

Temporary banking of the nipple-areola complex in breast reconstruction following breast resection including NAC, would be one of good surgical options for benign breast tumors like gigantomastia.

摘要

引言

巨乳症是一种乳腺疾病,其特征为乳房过度快速生长,通常为双侧性。在一些严重病例中,需要进行乳房切除术以确保安全分娩、控制疾病进展或复发。随后,大多数患者希望进行乳房重建,包括乳头乳晕复合体(NAC)。

病例介绍

在此,我们报告了一例因严重巨乳症接受乳房切除术患者的乳头乳晕复合体临时保存经验。每个乳头乳晕复合体被临时移植到腋窝作为日后乳头乳晕复合体重建的保存组织。尽管重建后乳头乳晕复合体的颜色略浅,但除了医学纹身技术外,其主要保持了原来的颜色和质地。目前,未出现复发,患者对其外观完全满意。

讨论

在该病例中,由于乳房尺寸过大导致无法安全分娩、出现呼吸和心脏并发症以及皮肤溃疡难以控制,因此建议进行乳房切除术。由于该疾病在病理上并非恶性,临时保存乳头乳晕复合体可使其在日后安全地再次用于乳头重建。

结论

在包括乳头乳晕复合体切除在内的乳房切除术后进行乳房重建时,临时保存乳头乳晕复合体将是治疗巨乳症等良性乳腺肿瘤的良好手术选择之一。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5533/7982491/9f36b53680bb/gr1.jpg

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