Gigantomastia with breast lipoma

Case contributed by Dr Ammar Ashraf

Presentation

Progressive bilateral breast enlargement along with a focal left breast mass for last three years. Mild pain in the left breast.

Patient Data

Age: 45 years
Gender: Female

Large bilateral fat density breasts. A radiolucent lesion measuring approximately 10.5 x 13 cm, surrounded by a thin radiopaque capsule, is noted in the upper outer quadrant of the left breast (best appreciable on the MLO view). No pleomorphic microcalcification clusters, concerning malignant lesion, abnormal skin thickening, nipple retraction or significant axillary lymphadenopathy is seen. 

Re-demonstration of a sizable radiolucent lesion in the upper outer quadrant of the left breast which now measures about 11 x 16 cm. There is interval development of two eggshell calcifications, measuring 11 x 17 mm and 4 x 5 mm within this lesion. 

Large fatty breasts. A sizable fatty mass lesion (isointense on T1 and T2-weighted images and low signal intensity on fat suppressed images) with thin capsule in the upper outer left breast, as seen on the mammogram. Two small calcified nodules (low signal intensity on both T1 and T2-weighted images) are noted within this left breast fatty mass. No significant enhancement is noted in the lesion on the post-contrast study. No suspicion neoplastic lesion is noted in either breast.

Histopathology report of the excised breast tissue. Left breast lesion was proven to be a lipoma containing some focal fat necrosis and dystrophic calcifications.

Case Discussion

  • The imaging features are suggestive of bilateral gigantomastia (also known as macromastia or mammomegaly) along with a lipoma in the left breast.
  • The patient underwent bilateral breast reduction mammoplasty as well as excision of the left breast mass. 

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