Gestational gigantomastia with fatal outcome

Abstract

Gigantomastia is a rare disease defined by an extreme and rapid enlargement of the breast, generally bilateral. The majority of cases are reported in pregnant women. Ninety-eight cases of gestational gigantomastia have been identified in electronic databases, and those with fatal outcomes comprised only 2 cases (2%). Despite its benign nature, it can lead to severe complications and even death. Its etiology has not been fully elucidated, but it has been speculated that a hormonal component may play a role in the pathogenesis. Currently, treatment options are limited, and surgery is gaining importance, but it is often not feasible in low-resource settings. Herein, we describe a case of a 30-year-old HIV-positive female with no relevant past medical history, who died due to the complications of gestational gigantomastia at the Maputo Central Hospital, in Mozambique.

Keywords: Breast Diseases; Gigantomastia; HIV; Pregnancy; Pregnancy Complications.

Figure 1. Gross view of the patient at 24 weeks of gestation in supine position showing a massive enlargement of both breasts with ulcers and necrosis of the overlying skin.

Figure 2. Photomicrograph of the breast parenchyma shows stromal edema, and ductal hyperplasia with mild dilation of breast ducts, with no signs of malignant transformation. A – Intralobular ducts are abundant and tortuous (H&E, 100X); B – Mild dilation of breast ducts. Scant inflammatory cells are seen in the stroma (H&E, 200X).