Home   Chapter Home   Jobs   Conferences   Fellowships   Books



Advertisement

Breast malignant, males, children

Childhood tumors

Juvenile fibroadenoma


Reviewer: Monika Roychowdhury, M.D. (see Reviewers page)
Revised: 18 November 2012, last major update August 2012
Copyright: (c) 2001-2012, PathologyOutlines.com, Inc.

Terminology
=========================================================================

● Also called giant fibroadenoma
● Not a distinct entity in WHO breast classification

Epidemiology
=========================================================================

● Usually adolescents, often African-American, often bilateral and with rapid growth to > 10 cm

Clinical features
=========================================================================

● May have atypical ductal hyperplasia suggestive of DCIS - low risk of carcinoma, but follow-up is recommended (Am J Surg Pathol 1987;11:184)

Prognostic features
=========================================================================

● Patients with multiple bilateral tumors should anticipate recurrence but not malignant change (Am J Surg Pathol 1985;9:730)

Case reports
=========================================================================

● 12 year old girl with Beckwith-Wiedemann syndrome and bilateral tumors (Ann Plast Surg 2010;64:803)
● 12 year old girl with bilateral giant tumors (Patholog Res Int 2011;2011:482046)
● 12 year old girl with bloody nipple discharge (Pediatr Neonatol 2010;51:190)
● 13 year old girl with hemihypertrophy and recurrent giant tumors (Breast Dis 2011;33:41)
● 13 year old girl with tumor exhibiting fibroadenomatoid hyperplasia (The Internet Journal of Surgery 2007;12:1)
● 15 year old girl with 3 kg tumor (J Pediatr Adolesc Gynecol 2009;22:e25)

Treatment
=========================================================================

● Excise but conserve as much breast tissue as possible (Breast J 2000;6:418)

Clinical images
=========================================================================



Various images

Gross images
=========================================================================



Various images

   
Bilateral giant juvenile fibroadenoma


Gray-white mass (fig 4)

Micro description
=========================================================================

● Stromal and epithelial hyperplasia, but no stromal atypia and no / rare stromal mitotic figures
● No periductal increase in cellularity, no stromal overgrowth, no cytologic atypia, mitotic rate < 3 / HPF (Stanford University)

Micro images
=========================================================================


               
Stromal and epithelial hyperplasia

   
Bilateral giant juvenile fibroadenoma

           

Cytology images
=========================================================================


         
Cluster of epithelial cells with    Epithelial cells and stromal fragments
mild pleomorphism        with few spindled cells


Branching sheets of epithelial cells with many bare nuclei and myxoid stromal fragments

Differential diagnosis
=========================================================================

Phyllodes tumor: rare in young patients, leaf-like growth pattern

End of Breast malignant, males, children > Childhood tumors > Juvenile fibroadenoma


This information is intended for physicians and related personnel, who understand that medical information is often imperfect, and must be interpreted in the context of a patient's clinical data using reasonable medical judgment. This website should not be used as a substitute for the advice of a licensed physician.

All information on this website is protected by copyright of PathologyOutlines.com, Inc. Information from third parties may also be protected by copyright. Please contact us at copyrightPathOut@gmail.com with any questions (click here for other contact information).