1/14. Florid juvenile (cellular) fibroadenomatosis in the adolescent: a case for subcutaneous mastectomy?Juvenile or giant fibroadenoma (JF) is an uncommon fibroadenoma variant usually presenting in adolescence. Although these masses are benign, when multiple and bilateral, they present a complex challenge to the attending surgeon, both in diagnosis, and in selection of the most appropriate therapy. Treatment is usually surgical and ranges from simple excision to subcutaneous mastectomy with reconstruction. We report an unusual case of refractory JF, initially treated with combined hormonal and surgical treatment but ultimately requiring bilateral subcutaneous mastectomies to prevent tumor regrowth. This case highlights the occasional difficulty in the management of macromastia in the adolescent female.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
2/14. Unilateral virginal breast hypertrophy.A case of unilateral virginal breast hypertrophy with a review of the etiological factors and treatment modalities is presented. A 16-year-old girl presented with progressive enlargement of the left breast of 5 months' duration. The result of the mammographic examination was consistent with cystosarcoma phyllodes. Fine-needle aspiration biopsy revealed giant fibroadenoma. Although some of the characteristics of the fine-needle aspiration biopsy specimen were suspicious for cystosarcoma phyllodes, there were no adequate epithelial structures, which are obligatory for the diagnosis. The patient was treated with subcutaneous mastectomy and subpectoral insertion of a silicone gel implant. The histopathological examination was consistent with virginal hypertrophy. The breast maintained its volume with no further growth in the affected or in the normal breast after 4 years of follow-up.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
3/14. Natural skin reduction and breast recovery using a tissue expander after enucleation of a giant breast tumour.We report a new use of the tissue expander for reshaping a breast after resection of a giant tumour. After resection of giant fibroadenomas, two patients had expanders inserted into the tissue defect and gradually reduced in size over five months. This facilitated healing and natural skin shrinkage and resulted in a natural shape and size.- - - - - - - - - - ranking = 6keywords = giant (Clic here for more details about this article) |
4/14. Multiple bilateral giant fibroadenomas associated with cyclosporine A therapy in a renal transplant recipient.A 31-year-old woman developed a right breast mass following cyclosporine A therapy after a renal transplant. Several large breast masses continued to grow bilaterally. mammography and ultrasonography showed features of giant fibroadenomas. The diagnosis was confirmed by biopsy of one of the masses. awareness of the association between cyclosporine A therapy and fibroadenoma development in renal transplant recipients is highlighted.- - - - - - - - - - ranking = 5keywords = giant (Clic here for more details about this article) |
5/14. Fine needle aspiration cytology of fibroadenoma with multinucleated stromal giant cells. A review of cases in a six-year period.OBJECTIVE: To describe the fine needle aspiration cytology findings of fibroadenoma with multinucleated stromal giant cells, with histologic correlation. STUDY DESIGN: The author reviewed the cytologic findings of two cases of fibroadenoma with multinucleated stromal giant cells from the file of Pamela Youde Nethersole Eastern Hospital in a six-year period from 1995 to the end of 2000. The diagnosis was confirmed by histologic examination of the lumpectomy specimens. RESULTS: The two cases had similar cytologic findings. The direct smears contained cohesive clusters of bland-looking ductal cells arranged in a "staghorn" pattern. Numerous naked nuclei were also seen in the background. Also, there were occasional multinucleated giant cells in isolation. These giant cells contained 5-10 randomly arranged, round to oval nuclei, fine chromatin and sometimes distinct nucleoli. The cytoplasm was abundant and pale staining, and the cell border was ill defined. Associated epithelioid histiocytes and foamy macrophages were not seen. Histologic examination of the lumpectomy specimens showed architectural features of fibroadenoma with pericanalicular and intracanalicular patterns. In addition, scattered multinucleated giant cells with focal degenerative change were noted in the tumor stroma. Their stromal nature was confirmed by immunohistochemical study. CONCLUSION: Multinucleated stromal giant cells are rarely identified in fine needle aspiration biopsies of fibroadenoma. Recognition of this peculiar finding may help to avoid misdiagnosis of other, more sinister conditions, such as phyllodes tumor and metaplastic carcinoma.- - - - - - - - - - ranking = 10keywords = giant (Clic here for more details about this article) |
6/14. Fine needle aspiration cytologic features of mammary phyllodes tumors.OBJECTIVE: To evaluate specific diagnostic fine needle aspiration cytologic (FNAC) features of phyllodes tumor (PT), particularly in the differentiation from fibroadenoma (FA). STUDY DESIGN: Twenty-eight FNAC of PT were reviewed for smear cellularity, epithelial and stromal fragments, their size and atypia, epithelial/stromal area ratio, background single stromal cells (oval or columnar), multinucleated giant cells, and squamous and apocrine cells. Twenty-one FNAC of fibroadenoma were also assessed for comparison. RESULTS: PT was significantly larger than FA. Epithelial fragments were found in all cases, with atypia present in PT. Stromal fragments were present in half the cases; there was no difference in stromal size, but the epithelial/stromal area ratio was significantly lower in PT than FA. Single columnar stromal cells with recognizable cytoplasm and multinucleated stromal giant cells were seen in some PT but not in FA. CONCLUSION: Cytologic diagnosis of PT remains difficult, with significant overlap with FA. The presence of large size, low epithelial/stromal ratio, epithelial atypia, columnar stromal cells with visible cytoplasm and stromal giant cells favors a diagnosis of PT over FA.- - - - - - - - - - ranking = 3keywords = giant (Clic here for more details about this article) |
7/14. Giant fibroadenoma of the breast.A case of giant fibroadenoma of the breast (size 23x20x13 cm and weight 2680 grams) in a 43-year-old woman with short stature and gracile body build is presented. Pericanalicular fibroadenoma was detected histologically. One year after mastectomy the patient is in good health, with no recurrences. The case is discussed in the light of the diagnostic difficulties, which lead to radical mastectomy. Giant fibroadenomas have to be differentiated from phylloid cystosarcoma by the lack of leaf-like structures and stromal cell atypia and from the breast hamartoma and asymmetric breast hypertrophy in girls by the lack of mammary lobules. Giant fibroadenoma should take its due place in the diagnostic algorithm of the breast tumors.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
8/14. Reduction mammoplasty in cases of giant fibroadenoma among adolescent females. case reports and literature review.Giant tumours of the breast cause massive enlargement of the breast resulting in asymmetry. Simple excision of the tumour fails to restore symmetry, and in some cases leaves the patient with a secondary deformity. We present two cases of giant fibroadenoma in adolescent females. Both patients underwent a one-stage excision of the giant fibroadenoma and reduction mammoplasty. Relevant operative details and results are presented together with a review of the literature.- - - - - - - - - - ranking = 6keywords = giant (Clic here for more details about this article) |
9/14. fibroadenoma of the breast in an 11-year-old girl.fibroadenoma is the main cause of unilateral breast mass in teenagers and adolescents. 4% of these are a special form described as giant or juvenile fibroadenoma. For primary diagnosis, ultrasound is the method of choice. The MRI allows exact evaluation of size and location. The fibroadenoma must be distinguished from the phylloid tumour, which can be malignant. The latter occurs in patients of all ages, but peaks between the ages 40 and 50 years. Only 2% of all primary malignant breast lesions are found in women aged under 25. Metastases of other primary tumours must be excluded, especially with a history of prior malignancies. When planning the surgical excision, the final cosmetic result is important. Although the main reason of an asymmetrical breast enlargement of young girls is a benign mass, an early surgical excision is efficient with regard to the best possible cosmetic outcome.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
10/14. Demonstration of polyclonal origin of giant fibroadenoma of the breast.We have shown that fibroadenoma of the breast is polyclonal and that phyllodes tumour is monoclonal in origin. It is not known whether a giant fibroadenoma which is histologically identical to the more usual type of fibroadenoma but grows to be a huge mass, like a phyllodes tumour, is polyclonal or monoclona. Clonal analysis was conducted on the dna samples extracted from the paraffin sections of a giant fibroadenoma resected from a 21-year-old woman. The method used was based on trinucleotide repeat polymorphism of the X-chromosome-linked androgen receptor gene and on random inactivation of the gene by methylation. Clonal analysis showed that the giant fibroadenoma and the adjacent normal breast tissue are polyclonal in origin. Although the term giant fibroadenoma has often been used interchangeably with the term benign phyllodes tumour, because of their similarity in clinical appearance, our present results demonstrate that a giant fibroadenoma is a polyclonal fibroadenoma that has attained an immense size and is different from the monoclonal phyllodes tumour.- - - - - - - - - - ranking = 9keywords = giant (Clic here for more details about this article) |
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