Recurrence of juvenile gigantomastia secondary to virginal hypertrophy: case report

Virginal mammary hypertrophy is a non-frequent benign medical affection, seen in teenagers, mainly during puberty.It consists on excessive bilateral or unilateral mammary growth, provoking physical and psychological dysfunctionality.Actually, there is no established algorithm for treatment, and the options available are based on published case reports.These options mainly include subcutaneous mastectomy, reduction mammoplasty and medical treatment with tamoxifen.In this article, we present the case of a prepubescent 12-year-old patient, who has not reached menarche yet.She presents excessive mammary growth suggestive of virginal mammary hypertrophy.She is addressed by a multidisciplinary group including oncologic surgeon, endocrinologist, gynecologist, and esthetic and reconstructive plastic surgeon.We decide to carry out surgical management, by performing a reduction mammoplasty with superior pedicle, obtaining satisfactory temporary results.Three months later, she presents new mammary growth, reaching 80% of the preoperatory volume.We decide surgical reintervention, carrying out a subcutaneous bilateral skin and nipple-sparing mastectomy, with immediate implant reconstruction as definitive treatment.Any case of juvenile gigantomastia merits multidisciplinary management,involving specialties such as endocrinology, psychology,pediatrics, and plastic and reconstructive surgery.