Zeeshan Sana, Shaikh Kulsoom, Tariq Muhammad Usman, Vohra Lubna Mushtaque
Section of Breast Surgery, Department of Surgery, The Aga Khan University, P.O. Box 3500, Stadium Road, Karachi, 74800, Pakistan.
Department of Surgery, The Aga Khan University, P.O. Box 3500, Stadium Road, Karachi, 74800, Pakistan.
Int J Surg Case Rep. 2021 Feb;79:450-454. doi: 10.1016/j.ijscr.2021.01.094. Epub 2021 Jan 28.
Fibroadenoma is the most common benign lesion of breast in young women, characterized by an aberrant proliferation of both epithelial and mesenchymal elements. It is termed giant fibroadenoma when it is larger than 5 cm or weighs more than 500 g with an incidence of 0.5-2% of all fibroadenomas.
In this report, we discuss a case of a 13-year-old Pakistani girl who presented with a giant juvenile fibroadenoma in left breast and was treated by a subareolar lump excision through a periareolar incision with excellent cosmetic outcome. To the best of our literature search, this is the first case of giant juvenile fibroadenoma in an adolescent being reported from Pakistan.
Surgical management of giant juvenile fibroadenoma in immature breast is challenging as it may either result in asymmetric defect or damage to developing breast tissue resulting in long term poor outcomes. Surgical decision should be carefully undertaken and reported for future reference in such cases.
The diagnosis and management of giant juvenile fibroadenoma can be challenging because these tumors clinically and histologically mimic phyllodes tumor due to their rapid growth and large size. Excision through a periareolar approach for fibroadenomas located in subareolar region provides good cosmetic results in these patients with minimal scar visibility.
纤维腺瘤是年轻女性中最常见的乳腺良性病变,其特征是上皮和间充质成分异常增殖。当纤维腺瘤大于5厘米或重量超过500克时,被称为巨大纤维腺瘤,其发生率占所有纤维腺瘤的0.5 - 2%。
在本报告中,我们讨论了一名13岁巴基斯坦女孩的病例,她左乳出现巨大青少年纤维腺瘤,并通过乳晕周围切口进行乳晕下肿块切除术进行治疗,美容效果极佳。据我们广泛的文献检索,这是巴基斯坦报道的首例青少年巨大青少年纤维腺瘤病例。
未成熟乳腺中巨大青少年纤维腺瘤的手术管理具有挑战性,因为这可能导致不对称缺损或对发育中的乳腺组织造成损伤,从而导致长期不良后果。在这种情况下,应谨慎做出手术决策并进行报告以供未来参考。
巨大青少年纤维腺瘤的诊断和管理可能具有挑战性,因为这些肿瘤由于其快速生长和大尺寸,在临床和组织学上类似于叶状肿瘤。对于位于乳晕下区域的纤维腺瘤,通过乳晕周围入路进行切除可使这些患者获得良好的美容效果,疤痕 visibility 最小。 (注:原文中“疤痕visibility”表述有误,可能是“疤痕可见度”之类的意思,这里按原文翻译)