Breast reconstruction using a tissue expander after enucleation of a giant fibroadenoma: A case report

Mai Kitazawa; Manabu Futamura; Yoshihisa Tokumaru; Keishi Kohyama; Akira Nakakami; Kazuhiro Yoshida

doi:10.1016/j.ijscr.2021.106723

Breast reconstruction using a tissue expander after enucleation of a giant fibroadenoma: A case report

Int J Surg Case Rep. 2022 Jan:90:106723. doi: 10.1016/j.ijscr.2021.106723. Epub 2021 Dec 24.

Authors

Mai Kitazawa¹, Manabu Futamura², Yoshihisa Tokumaru¹, Keishi Kohyama³, Akira Nakakami¹, Kazuhiro Yoshida⁴

Affiliations

¹ Breast Surgery, Department of Surgery, Graduate School of Medicine, Gifu University, 1-1 Yanagido, Gifu 501-1194, Japan.
² Breast Surgery, Department of Surgery, Graduate School of Medicine, Gifu University, 1-1 Yanagido, Gifu 501-1194, Japan. Electronic address: mfutamur@gifu-u.ac.jp.
³ Department of Plastic and Reconstructive Surgery, Gifu University Hospital, 1-1 Yanagido, Gifu 501-1194, Japan.
⁴ Gastroenterological Surgery, Department of Surgery, Graduate School of Medicine, Gifu University, 1-1 Yanagido, Gifu 501-1194, Japan. Electronic address: kyoshida@gifu-u.ac.jp.

Abstract

Introduction: Fibroadenomas are among the most common benign tumors in women. Juvenile giant fibroadenomas account for nearly 0.5% of all fibroadenomas. Due to its size, a giant juvenile fibroadenoma leaves a large defect or deformity after its resection. The optimal surgical management strategy for giant juvenile fibroadenomas remains unclear. Here, we report a case of successful breast reconstruction without residual deformity through gradual deflation of a saline-filled tissue expander after resection of a giant juvenile fibroadenoma.

Presentation of case: A 14-year-old girl with a growing tumor in her left breast presented to a private clinic. Given that the tumor was 8 cm in size, phyllodes could not be ruled out. Consequently, she was referred to our hospital for further examination and treatment. Core needle biopsy confirmed the tumor to be a fibroadenoma. We resected the tumor and inserted a tissue expander filled with 120 mL of saline, matching the area of the large defect caused by tumor resection. We removed approximately 25 mL of saline every 3 weeks to aid normal mammary tissue enlargement. After completely draining saline from the tissue expander and confirming an acceptable enlargement of the residual mammary gland, we performed an operation to remove the tissue expander. Follow-up revealed that the symmetry and contour of the breast were excellent after the second operation.

Conclusions: Our observations suggest that using a tissue expander to enlarge normal mammary tissue may help reconstruct large defects caused by excision of benign tumors.

Keywords: Breast reconstruction; Giant juvenile fibroadenoma; Tissue expander.