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孕妇中快速生长的纤维腺瘤:病例报告。

A rapidly growing fibroadenoma in a pregnant woman: A case report.

机构信息

Department of Surgery, Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands.

Department of Pathology, Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands.

出版信息

Breast Dis. 2023;42(1):325-330. doi: 10.3233/BD-230030.

Abstract

BACKGROUND

Fibroadenomas are the most common benign breast lesions in women. They present as a unilateral mass and can rapidly enlarge in size through hormonal changes. Fibroadenomas could be classified as small or giant, and as simple or complex. They are classified as 'giant' when the size exceeds 5 cm and/or weight 500 gram; and as 'complex' if one of the following characteristics is present: cysts with a size >3 mm, epithelial calcifications, sclerosing adenosis and papillary apocrine metaplasia. Giant fibroadenomas can cause compression of surrounding breast tissue or breast asymmetry, requiring surgical excision in order to preserve a normal breast shape.

CASE

A 26-year-old pregnant woman was referred with a palpable mass of her right breast. The mass rapidly increased in size to a diameter of 13 cm during the second trimester of her pregnancy. A tru-cut biopsy confirmed a fibroadenoma. The rapid growth and compression of normal breast tissues indicated a lumpectomy during her pregnancy. The mass was easily excised without any consequences for the pregnancy. Pathological examination showed a complex giant fibroadenoma.

CONCLUSION

A unique case of a pregnant woman with rapid progression of a fibroadenoma that met the criteria of a complex and giant fibroadenoma, was presented. This case emphasizes the importance of timely surgical intervention, even during pregnancy, to prevent permanent breast tissue damage.

摘要

背景

纤维腺瘤是女性最常见的良性乳腺病变。它们表现为单侧肿块,并且可以通过激素变化迅速增大。纤维腺瘤可以分为小或大,简单或复杂。当大小超过 5 厘米和/或重量超过 500 克时,被归类为“巨大”;如果存在以下特征之一,则被归类为“复杂”:大小>3 毫米的囊肿、上皮钙化、硬化性腺病和乳头状大汗腺化生。巨大纤维腺瘤可导致周围乳腺组织受压或乳房不对称,为了保持正常的乳房形状需要手术切除。

病例

一名 26 岁的孕妇因右乳房可触及肿块就诊。肿块在妊娠中期迅速增大至 13 厘米直径。 tru-cut 活检证实为纤维腺瘤。快速生长和正常乳腺组织受压表明在妊娠期间进行肿块切除术。肿块很容易切除,对妊娠没有任何影响。病理检查显示为复杂的巨大纤维腺瘤。

结论

本病例报道了一例罕见的孕妇纤维腺瘤快速进展的病例,符合复杂和巨大纤维腺瘤的标准。该病例强调了即使在怀孕期间,及时进行手术干预以预防永久性乳腺组织损伤的重要性。

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