VIRGINAL RECURRENT GIGANTOMASTIA (BREAST HYPERTROPHY). A CASE REPORT.

V Cheshuk, M Anikusko, V Kozina, V Ulishchenko, M Malec
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Abstract

Virginal gigantomastia (VGM) is a benign disease of the breasts without a clearly established etiology. The treatment of VGM remains a problem. The conservative treatment is not effective while surgery is too traumatic. Most specialists recommend subcutaneous mastectomy with immediate implant reconstruction or reduction mammoplasty. The reduction mammoplasty with adjuvant hormone therapy is a variant of treatment of young patients with a risk of recurrence. We present a case of a patient with VGM who was operated in 2014. Reduction mammoplasty was performed. After 9 years, the patient had a relapse and second surgery, resection of the breasts with reduction mammoplasty. Tissues with cysts, fibrosis, hamartomas, and fibroadenomas were dissected. Histopathology revealed extensive fibrosis with hamartomas and fibroadenomas. The immunohistochemical examination of the breast tissue showed a high level (70%) of estrogen and progesterone receptors expression. We prescribed hormone therapy with tamoxifen 10 mg per day. Dynamic monitoring of the treatment result and control of the disease remission was carried out. Breast-conserving surgery performed in such patients can help alleviate the psychological, social, and physical disorders caused by VGM.

处女膜复发性巨乳症(乳房肥大症)。病例报告。
处女膜巨乳症(VGM)是一种没有明确病因的乳房良性疾病。畸形巨乳症的治疗仍然是一个难题。保守治疗效果不佳,而手术创伤又太大。大多数专家建议进行皮下乳房切除术,并立即进行假体重建或乳房缩小整形术。缩小乳房成形术配合辅助激素治疗是治疗有复发风险的年轻患者的一种变体。我们介绍了一例于 2014 年接受手术的 VGM 患者。患者接受了乳房缩小成形术。9 年后,患者复发,进行了第二次手术,切除乳房并进行乳房缩小术。切除的组织包括囊肿、纤维化、瘤和纤维腺瘤。组织病理学检查显示,乳房广泛纤维化,并伴有乳房腺瘤和纤维腺瘤。乳腺组织的免疫组化检查显示雌激素和孕激素受体表达水平较高(70%)。我们给她开了激素治疗的处方,他莫昔芬每天 10 毫克。我们对治疗效果进行了动态监测,并控制病情缓解。对此类患者实施保乳手术有助于缓解 VGM 引起的心理、社会和生理障碍。
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