Journal of Reproduction & Infertility

Journal of Reproduction & Infertility

A Rare Case of Gestational Gigantomastia with Hypercalcemia: The Challenges of Management and Follow up

Authors
Bahram Moazzami 1
Shahla Chaichian 2
Mohammad Reza Farahvash 3
Saeedeh Taheri 1
Seyed Ali Ahmadi 4
Majid Mokhtari 5
Kourosh Sheibani 6
1 Pars Advanced and Minimally Invasive Manners Research Center, Pars Hospital, Iran University of Medical Sciences, Tehran, Iran
2 Minimally Invasive Techniques Research Center in Women, Tehran Medical Sciences Branch, Islamic Azad University, Tehran, Iran
3 Department of Plastic Surgery, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
4 Department of Pathology, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
5 Department of Medicine, Pulmonary and Critical Care Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
6 Clinical Research and Development Center, Imam Hossein Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Abstract
Background: Gigantomastia is a breast disorder marked by exaggerated rapid growth of the breasts, generally bilaterally. Since this disorder is very rare and has been reported only in sparse case reports its etiology has yet to be fully established. Treatment is aimed at improving the clinical and psychological symptoms and reducing the treatment side effects; however, the best therapeutic option varies from case to case. Case Presentation: The present report described a case of gestational gigantomastia in a 30-year-old woman, gravida 2, parity 1, 17 week pregnant admitted to Pars Hospital, Tehran, Iran, on may 2014. The patient was admitted to hospital at week 17 of pregnancy, although her breasts initially had begun to enlarge from the first trimester. The patient developed hypercalcemia in her 32nd week of pregnancy. The present report followed this patient from diagnosis until the completion of treatment. Conclusion: Although gestational gigantomastia is a rare condition, its timely prognosis and careful examination of some conditions like hyperprolactinemia and hypercalcemia is essential in successful management of this condition.
Keywords
Breast
Diagnosis
gestational age
Gigantomastia
Hypercalcemia
Iran
Therapeutics
  1. Ezem BU, Osuagwu CC, Opara KA. Gestational gigantomastia with complete resolution in a Nigerian woman. BMJ Case Rep. 2011;2011.
  2. Vidaeff AC, Ross PJ, Livingston CK, Parks DH. Gigantomastia complicating mirror syndrome in pregnancy. Obstet Gynecol. 2003;101(5 Pt 2):1139-42.
  3. Antevski BM, Smilevski DA, Stojovski MZ, Filipovski VA, Banev SG. Extreme gigantomastia in pregnancy: case report and review of literature. Arch Gynecol Obstet. 2007;275(2):149-53.
  4. Zargar AH, Laway BA, Masoodi SR, Shah NA, Darzi MA, Wani AH. Gestational macromastia not responding to termination of pregnancy. Postgrad Med J. 1995;71(832):124-5.
  5. Williams PC. Massive hypertrophy of the breasts and axillary breasts in successive pregnancies. Am J Obstet Gynecol. 1957;74(6):1326-9.
  6. Zargar AH, Laway BA, Masoodi SR, Chowdri NA, Bashir MI, Wani AI. Unilateral gestational macromastia--an unusual presentation of a rare disorder. Postgrad Med J. 1999;75(880):101-3.
  7. Lafreniere R, Temple W, Ketcham A. Gestational macromastia. Am J Surg. 1984;148(3):413-8.
  8. Eler Dos Reis P, Blunck Santos NQ, Barbosa Pagio FA, Chambo F, Chambo D, Chambo Filho A. Management and follow-up of a case of gestational gigantomastia in a brazilian hospital. Case Rep Obstet Gynecol. 2014;2014:610363.
  9. Agarwal AA, Sonkar AA, Kushwaha JK, Singh S. Gestational hypertrophy of the breast. BMJ Case Rep. 2013;2013.
  10. van Wingerden JJ. Gigantomastia--definition and association with hypercalcaemia. J Plast Reconstr Aesthet Surg. 2009;62(1):112-4.
  11. Bloom SA, Nahabedian MY. Gestational macromastia: a medical and surgical challenge. Breast J. 2008;14(5):492-5.
  12. Van Heerden JA, Gharib H, Jackson IT. Pseudohyperparathyroidism secondary to gigantic mammary hypertrophy. Arch Surg. 1988;123(1):80-2.
  13. Amaya Garcia M, Acosta Feria M, Soto Moreno A, Dios Fuentes E, Navarro Gonzalez E, Quijada Thong D, et al. Primary hyperparathyroidism in pregnancy. Gynecol Endocrinol. 2004;19(2):111-4.
  14. Lapid O. Breast reconstruction after mastectomy for gestational gigantomastia. Aesthetic Plast Surg. 2013;37(2):388-91.
  15. Rinker B, Thornton BP. Skin-sparing mastectomy and immediate tissue expander breast reconstruction in patients with macromastia using the Passot breast reduction pattern. Ann Plast Surg. 2014;72(6):S158-64.
  16. Rahman GA, Adigun IA, Yusuf IF. Macromastia: a review of presentation and management. Niger Postgrad Med J. 2010;17(1):45-9.
  17. Karagulle E, Turk E, Erinanc OH, Moray G. Giant fibroadenoma growing rapidly during pregnancy. Iran Red Crescent Med J. 2014;16(8):e9531.
Journal of Reproduction & Infertility
Volume 17, Issue 4
Autumn 2016
Pages 243-246