Excision of Giant Fibroadenoma via Circumareolar Incision: A Case Report

Abstract Introduction: Giant fibroadenomas are a variant of breast lesions that differ from ordinary fibroadenomas in their tendency to grow much larger, over 5cm in diameter, or weighing more than 500g. They are commonly found in teenage and young adult females and can pose challenges in terms of diagnosis and treatment due to their substantial size and rapid growth rate. Here, we report our first case of giant fibroadenoma and its management by circumareolar incision, in our center. Case presentation: A 20-year-old girl presented with a painless lump in the left breast, progressively increasing in size over six months. One paternal aunt had breast cancer at the age of 50. On examination, there was a large 10*10cm lump in the left breast, occupying almost the whole of the left breast, which was mobile and well-defined. Ultrasound imaging was suggestive of a large soft tissue mass of mixed echogenicity. Core needle biopsy confirmed giant fibroadenoma. An excision biopsy through a circumareolar incision was performed. Histopathology confirmed Giant fibroadenoma. The patient had a smooth post-operative recovery; no hematoma or seroma was noted after 2 months of follow-up and excellent cosmesis was attained with almost no visible scar. Discussion: Giant fibroadenoma is an uncommon benign tumor of the breast mostly affecting adolescents and young females. This kind of tumor is usually characterized by rapid growth, sometimes sizeable, which may cause asymmetry, pain, and pressure on the surrounding tissues. While fibroadenomas are relatively common in younger women, cases classified under the category "giant", especially those occurring in juveniles are rare and pose diagnostic and management challenges. Conclusion: Giant fibroadenomas must be differentiated from phyllodes tumors& malignancy through the appropriate triple assessment, which encompasses obtaining a proper history, physical examination, imaging assessment, and tissue biopsy. Surgical excision is an effective intervention and circumareolar incision is an excellent approach to assure cosmesis Keywords: Giant fibroadenoma; Breast; Circumareolar incision; Excision