Giant juvenile fibroadenoma: A case report

• Published in: International journal of surgery case reports 2024-08, Vol.121, p.109897, Article 109897
• Main Authors: El Graini, Soumya, El Hassouni, Fatima, Rouas, Lamia, Fathi, Khalid, Chat, Latifa, El Haddad, Siham
• Format: Article
• Language: English
• Subjects: Case Report; Fibro-epithelial tumour; Giant juvenile fibroadenoma; Tumour phyllode
• ISSN: 2210-2612; 2210-2612
• DOI: 10.1016/j.ijscr.2024.109897

Breast pathology in adolescents is rare and predominantly benign, with abnormalities including congenital anomalies, infections, mastodynia, nipple discharge, and mostly benign breast masses. Fibroepithelial tumors, the most common type, form a heterogeneous group that includes benign, borderline, and malignant entities such as phyllodes tumors. Differentiation of these tumors, especially various types of fibroadenomas, requires histopathological examination due to their similar radiological appearances and lesion heterogeneity. Recognizing the nature of these lesions is crucial to avoid missing malignant forms with metastatic potential. Giant juvenile fibroadenoma is a quite rare benign fibroepithelial tumour, that cannot be differentiate from phyllodes tumors before anatomopathological examination. We report the case of a 14-year-old patient who presented with a rapidly enlarging mass in the left breast, and the diagnosis of giant juvenile adenofibroma was confirmed after surgical treatment. Giant juvenile fibroadenomas occurs in adolescent girl and constitutes 0.5 % - 4 % of all fibroadenomas cases. When it exceeds 5 cm, weighs more than 500 g, or occupies more than 4/5 of the breast, it is considered as giant. It is characterized by a rapid increase in size, causing distortion and compression of the breast. Breast ultrasound is the first imaging modality, showing a large, well-limited hypo or iso echoic mass. The main differential diagnosis should be made with phyllodes tumors. The diagnosis is considered based on clinical and radiological features but is confirmed only after surgical excision of the mass and histological study. The discovery of a breast mass in an adolescent should prompt further investigations to avoid overlooking a fibroepithelial tumour. The most probable diagnoses are giant juvenile fibroadenoma and phyllodes tumors. •Breast masses in adolescents are usually benign, with fibroepithelial tumors being the most common type•Giant juvenile fibroadenoma is a rare entity, occurring in young between 10 and 18 years, manifesting as a giant mass exceeding 5 cm, 500g in weight or occupying a significant portion of the breast volume.•The main differential diagnosis is phyllodes tumors, and can only be distinguish with histological examination.•The treatment is based on surgical excision with breast reconstruction to insure a satisfactory aesthetics outcome for the patient.