Rare condition characterized by an intensive and excessive breast enlargement is known as gigantomastia. Gestational gigantomastia manifests during pregnancy and could represent a life-threatening condition for both the mother and the fetus, therefore the risk of spontaneous abortion complicates the choice of treatment approach. We present a clinical case of a patient requesting medical assistance with a progressive breast growth. The onset occurred on the 5th week of gestation and, subsequently, was aggravated by distal tissue necrosis. The ambiguity of treatment approach in such situation is based on, on the one hand, the insecurity of watch-and-wait approach due to the high risk of septic complications and, on the other hand, the increasing danger of fetal loss in the case of surgical treatment during the first trimester of pregnancy. After an adequate assessment of mothers health state, a decision was made towards the wait-and-see tactic until the complete formation of the placental barrier. A total bilateral mastectomy was performed at the 19th week of pregnancy, with a favorable outcome for the patient and her child. This case emphasizes the significance of an individual, interdisciplinary approach to the choice of management for patients with this pathology.
Riedel`s thyroiditis is a rare disease with an unknown etiology, which is characterized by replacement of the thyroid gland tissue with a fibrous connective tissue, the main characteristic sign is the stony-hard texture of the gland, extending to the surrounding structures (trachea, esophagus, blood vessels and nerves). Dense adhesion causes clinical symptoms of tracheal compression, such as shortness of breath, hoarseness, coughing and dyspnoea. Regarding functional activity, both euthyroidism and thyrotoxicosis with the subsequent development of hypothyroidism can be observed. A difficult preoperative diagnosis allows only to suspect this disease, as well as differentiate it with some aggressive forms of cancer, and therefore the final diagnosis is possible only after histological and immunohistochemical examinations of postoperative material. The conservative treatment (mainly glucocorticoid drugs) and surgical intervention can be applied. It is necessary to be meticulous about the choice of a treatment method, taking into account the firmly adhesion with surrounding structures and a high risk of complications of surgical treatment of the thyroid gland. This case report describes a patient with a confirmed morphological diagnosis of Riedelapos;s thyroiditis after thyroidectomy. The peculiarity of this case is a clear positive correlation of the occurrence of subfebrile fever with the onset of the disease and its resolution after surgical treatment and a 11-month follow-up period.
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