Gigantomastia in pregnancy and puerperal period

case report

Abstract

Gestational gigantomastia is a rare condition of excessive growth of the breasts during pregnancy. The etiology is unknown, and the incidence ranges from 1/2.800 to 1/100.000 pregnancies. Excessive growth of the breasts, with significant increase in volume and weight, causes discomfort to wander around or stand. Excessive weight on the chest causes discomfort to breathe. Tissue necrosis may occur, probably due to insufficient vascularization of skin, forming ulcerations, as well as secondary infection and bleeding. By having unknown etiology, there is no specific treatment. The patient should be instructed on the progressive growth and the difficulties associated with it, as well as be given clinical support for the treatment of complications. These pregnancies often end in premature births, because the patient has difficulty to support the breasts’ weight. Lactation should be inhibited to prevent infections and discomfort for the patient. As it occurs volume regression in the postpartum, it may be required mammoplasty to remove the excess skin. Due to vascular increase and the consequent risk of major bleeding, surgical treatments are not indicated during pregnancy. This article reports the case of a 15 years old primipara who had excessive and asymmetric growth of the left breast during pregnancy. Admitted to our hospital on the 12th day postpartum, she presented massive, hyperpigmented and brownish left breast, with diffusely increased consistency. Ultrasound examination showed diffuse enlargement of breast tissue. Lactation was inhibited, and a weekly follow-up was held. The patient presented galactocele approximately 10 cm long, which was surgically removed