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Breast-nonmalignant
General
Pubertal (virginal) macromastia
Reviewer: Hind Nassar, M.D. in January 2009 (see Authors page)
Revised: 24 September 2012, last major updated March 2010
Copyright: (c) 2002-2010, PathologyOutlines.com, Inc.
Definition
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● Occasionally breasts undergo rapid and massive enlargement at puberty
● If unilateral, usually due to fibroadenoma (J Pediatr Adolesc Gynecol 2009;22:e25)
Terminology
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● Also called gigantomastia
Epidemiology
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●
Etiology
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● Rarely familial with congenital anonychia (lack of nails, J Adolesc Health 2004;35:151)
Clinical features
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● Rarely associated with autoimmune disease (J Clin Endocrinol Metab 2005;90:5287)
● Diffusely enlarged breasts with flattening of nipples
● Gestational gigantomastia is much less common; may require bilateral mastectomy (Plast Reconstr Surg 2006;118:840)
Prognostic factors
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●
Case reports
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●
Treatment
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● Reduction mammoplasty usually needed; may recur (Ann Plast Surg 2001;46:517)
● Tamoxifen may be helpful
Clinical images
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Autoimmune related cases Unilateral enlargement
Micro description (Histopathology)
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● Abundant connective tissue separating ducts, usually poorly developed or no lobules
● May resemble gynecomastia
Micro images
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AFIP Fig 11: 15 year old girl with massive bilateral enlargement
of breasts, dense connective tissue, only minimal lobular development
Dense fibrosis with severe lobular atrophy
Differential Diagnosis
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● (link to topic)
Additional references
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End of Breast-nonmalignant > General > Pubertal (virginal) macromastia
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