Giant juvenile fibroadenoma of the mammary gland (analytical review of the literature and personal observation)

Fibroadenoma refers to widespread tumors of the mammary gland in childhood, while their nature is very different from pathology in adults. Giant juvenile fibroadenoma of the mammary gland belongs to the benign formations of the mammary gland, the structure of which consists of estrogen-sensitive epithelial and stromal tissues, the frequency of which reaches up to 27.9% in the pre- and 72.1% in the postmenarchal periods. Aim is to highlight the experience of diagnosing and treating giant juvenile fibroadenoma of the breast on an analytical review of literature and clinical case example. The article presents a clinical case that demonstrates the clinical course of a giant fibroadenoma of the mammary gland, as well as the method of surgical treatment of this pathology using mastopexy after tumor removal, which leads to a good cosmetic effect in the postoperative period. The diagnostic algorithm for giant juvenile fibroadenoma of the mammary gland consists of determining the visual and palpable changes of the mammary gland and involving certain additional examinations with the help of ultrasound, mammography, MRI and biopsy, which also help in differential diagnosis. Doppler ultrasound in 80% of cases reveals hypervascularization of the mammary gland. Differential diagnosis of giant juvenile fibroadenoma of the mammary gland is carried out with phylloid tumors, pseudoangiomatous stromal hyperplasia, virginal hypertrophy, hamartoma, lipoma, breast abscess, macrocyst, adenocarcinoma. Undisputed indications for surgical treatment of giant juvenile fibroadenoma of the mammary gland are suspicious characteristics during its visualization, including during ultrasound (increase in the density of intra-tissue vascularization) and rapid growth of the tumor formation. The need to remove a giant juvenile fibroadenoma of the mammary gland at a young age is also due to the preservation of the ability to lactate, minimizing injury to the mammary gland, supporting the development of its parenchyma by reducing the hypoxic effect of compression on normal tissue and good cosmetic results, which is also of great importance. Conclusions. Giant juvenile fibroadenoma of the mammary gland refers to rare tumors in girls during puberty, which are characterized by rapid growth and deformation of the mammary gland. The final diagnosis is possible only through morphological verification. After the diagnosis, a satisfactory oncological and cosmetic result is possible with timely surgical intervention and appropriate rehabilitation. The research was carried out in accordance with the principles of the Helsinki Declaration. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.