First Known Case of Juvenile Gigantomachia in the United Kingdom - A Case Report

Gigantomastia is a rare condition which remains poorly understood.There is no universally accepted definition, however breast weight exceeding 3% of total body weight has been proposed.Juvenile gigantomastia, a subtype, involves sudden onset, excessive growth of breast tissue in relation to puberty and can occur before or after the onset of menstruation.This paper reports on the first known case of juvenile gigantomastia seen in the United Kingdom.A 16-year old female presented with a 12-month history of rapid breast growth.She had no other medical problems and no relevant family history.Examination revealed bilaterally enlarged breasts extending to the level of the anterior superior iliac spine, with enlarged superficial veins, ill-defined areola and areas of skin ulceration.A range of hormone and autoimmune tests were performed with all results found to be normal.After MDT discussion, the treatment of choice was reduction mammoplasty with an inferior pedicle technique and free nipple grafting if necessary.The total volume of tissue removed weighed 10.9 kg; 6.6 kg from the right breast, 4.3 kg from the left breast.Initial post-operative results demonstrate a highly satisfactory reduction with minimal scarring and no further growth of breast tissue.Histology showed a benign pattern secondary to extensive proliferation of glandular and stromal tissue.The tissue tested positive for both oestrogen and progesterone receptors and so the decision was made to treat the patient with tamoxifen until the age of 21 years in order to prevent recurrence.To our knowledge, this is the first reported case of juvenile gigantomastia in the UK.