A prepubertal giant juvenile fibroadenoma in a 12-year-old girl: Case report and brief literature review

Abstract

Introduction: Giant juvenile fibroadenomas represent only the 0.5% of all fibroadenomas, constituting a rare condition in adolescence. In prepuberty, the presence of this condition is extremely rare.

Presentation of case: We describe a rare case of a 12- year-old Caucasian girl who presented to our Hospital complaining of a palpable mass with rapid enlargement in her right breast that she had first noticed 3 months ago. Her menarche hadn't occurred yet.

Discussion: Physical examination showed a giant mass of 15 × 13 cm in the right breast. The patient was further evaluated via ultrasonography showing a sole large lesion of 13 × 12 cm in the right breast. A surgical procedure under general anesthesia was performed. Histopathological findings after the surgical excision were suggestive of giant juvenile fibroadenoma. The patient has a normal breast development over a period of 9 month follow up.

Conclusion: Giant juvenile fibroadenomas should be included in differential diagnosis of a breast mass in prepubertal girls despite the fact that they are very rare in prepuberty, tend to appear later during adolescence and their prevalence is lower in Caucasians. The remarkable size and the rapid growth of the lesion should not be ruled out in the diagnostic process of an adolescent breast.

Keywords: Adolescence; Breast; Fibroadenoma; Giant juvenile fibroadenoma; Prepuberty.

Fig. 1

Breast ultrasonography; a–c. B-Mode – well defined, encapsulated, lobulated, iso- to hypoechoic mass with small cystic spaces; d–f. Color Doppler – Increased internal vascularity.

Fig. 2

a. Preoperative image of the breast; b–e. Intraoperative images of the mass; f, g. postoperative images of the breasts.

Fig. 3

Histopathological images after haematoxylin- eosin stain; a, b. Juvenile fibroadenoma is characterized by stromal cellularity, epithelial hyperplasia and more often by pericanalicular architecture.