Reconstruction of a rare case of bilateral juvenile gigantomastia at a tertiary hospital: a case report

Introduction: Juvenile gigantomastia is a rare benign breast pathology that predominantly affects adolescents and women younger than 18 years of age. It is characterized by excessive, diffuse enlargement of the breast tissue (more than 1.5–2.5 kg per breast or constituting over 3% of total body weight), involving both glandular and stromal components. The histological picture consists of a juvenile fibroadenoma (JFA), which represents a distinct subtype of fibroepithelial breast tumor. The condition can cause severe physical discomfort, pain, posture abnormalities, recurrent skin infections, difficulties with mobility and personal hygiene, low self-esteem, and social stigma. Case presentation: A 15-year-old female presented with a 1-year history of progressive bilateral breast enlargement without nipple discharge, systemic symptoms, or trauma. On local examination, the breasts were grossly enlarged, soft, and non-tender on palpation, with the skin overstretched and visible ulcerations. Modified Goldilocks reduction mammoplasty was performed after excluding other pathologies through a breast ultrasound and hormonology report. Histology reported JFA. Discussion: JFA is a rare form of benign breast tumor, which manifests during puberty and leads to excessive breast development (gigantomastia) and its related discomfort. It is hypothesized that the causes are due to hypersensitivity of breast tissue to normal circulating estrogens, and hormonal therapy has been reported as a possible treatment, but surgery is considered the definitive treatment. Counseling on follow-up plans should be done to detect complications and recurrence. Conclusion: JFA patients seek care for physical disability and psychological distress. Surgical intervention is the definitive treatment, and histology confirms the diagnosis.