Un cas de gigantomastie gravidique bilatérale

Abstract

We here report the case of a 29-year old gravida 2, para 2 patient with no particular past medical history. Symptoms evolved over 2 months and were marked by bilateral breast growth impairing her daily activities. Clinical examination showed hypertrophied breasts and bilateral breast ulcers. She had a history of 28-weeks amenorrhea. Anatomopathological examination of ulcers showed fleshy bud-like tissue. The patient had high levels of prolactin (1345 µUI/ml). The levels of FSH and LH were normal. The patient underwent bromocriptine therapy without success. Patient's evolution was marked by decrease in size and regression in skin ulcers six months after vaginal birth. Gestational gigantomastia is a breast hypertrophy characterized by a breast volume exceeding 1500 cm 3 . Its cause is unknown. Radical treatment is based on bilateral mastectomy.

Gestational gigantomastia with fatal outcome

“…6,9 Patients with GG may develop breast ulceration, hemorrhage, cellulitis, pain, decreased mobility, and can be also be psychologically affected. 6,[10][11][12] The etiology remains unclear; however, it is believed to arise as a result of over-sensitivity or overproduction of pregnancy-related hormones, such as prolactin. 7,13 Alternatively, autoimmunity may also play a role in its pathogenesis; 14 indeed, the simultaneous presence of autoimmune diseases has been reported in several cases.…”

“…6 The main complications in the reported cases of severe GG are associated with skin ulceration, bleeding and necrosis. 6,[9][10][11][12][23][24][25] Indeed, breast ulceration, infection, and bleeding are potentially fatal complications and constitute absolute indications for surgical treatment. Unfortunately, urgent surgical intervention was not feasible in our case due to logistic factors, and the patient died due to hemorrhage.…”