When asymmetry becomes “giant”: A Rare Case of Juvenile Fibroadenoma

Abstract

Juvenile fibroadenoma account for approximately 4% of all fibroadenomas, and giant juvenile fibroadenomas are extremely rare, with an incidence of 0.5%. Fibroadenomas can reach large sizes, and surgical intervention poses an aesthetic challenge, particularly in developing breasts. We report the case of a 13-year-old girl who presented with rapid enlargement of the left breast. Physical examination revealed a long-linear morphotype with marked asymmetry due to a voluminous mass occupying the entire left breast, rendering the nipple-areolar complex (NAC) indistinct owing to subcutaneous tension. The mass was firm, non-tender, and without inflammatory signs, and no axillary lymphadenopathy was detected on imaging. Breast ultrasonography revealed a large, well-circumscribed, ovoid, solid, and vascularized lesion measuring 100 × 50 × 110 mm, compressing the surrounding glandular tissue. Ultrasound-guided core biopsy suggested a diagnosis of juvenile fibroadenoma. The patient underwent tumorectomy via an inframammary incision and was discharged the following day without complications. Histopathological examination confirmed a giant juvenile fibroadenoma weighing 373 g and measuring 115 mm × 91 mm × 57 mm, with complete excision. Surgical excision with histological analysis remains the treatment of choice for this condition. Follow-up demonstrated good aesthetic outcomes, which positively impacted the patient’s self-esteem.