Giant Fibroadenoma with Breast Reduction

Firmansyah Putra*, M. A Yudi Pribadi*, Budi Irwan**

*Resident of General Surgery, Department of Surgery, Medical Faculty
University of Sumatera Utara
**Consultant Sub Division of Digestive Surgery, Department of Surgery, Medical Faculty University of
Sumatera Utara, National H. Adam Malik General Hospital
Introduction
Fibroadenomaisacommonbenigntumoroftheadolescentandyoungadultfemalebreast.Giantfibroadenoma
(GFA)ontheotherhandarethosefibroadenomasthatarelargerthan5cmandorweighmorethan500g.They
arenotascommonassmallfibroadenomas.GFAisthemostcommonbenignlesioncausingunilateralbreast
enlargementinyoungpatients.SomelargeunilateralGFAdoproducesignificantbreastasymmetry.Itcan
becomeacosmeticproblemfortheaffectedpatientwithseriouspsychologicaleffects(Hille).Variousmethod
toaddressthispostoperativeasymmetryincluderelianceonpostoperativesofttissueshrinkage,useofbreast
implant or tissue expander (Achebe). This study aims to evaluate the excision of fibroadenomas using ?
approachwithsimultaneousplasticreconstruction.
Case Report
A 26 year old Man, came to the hospital Haji Adam Malik Medan with complaints of yellowish eyes, This is
since 7 month before to the admissions. Computed tomography scan of abdomen showed 5 3 4 cm lesion on
the pancreatic head, dilatation CBD, bile duct intrahepatic with hydrops gallbladder. Serum tumor markers were
carcinoembryonic antigen (CEA): 0.8 ng/mL and carbohydrate antigen 19-9 (CA 19.9): 50 U/mL. The patient
was submitted to a duodenum-preserving pancreatic head resection.
Result
The operative time was 400 min with blood loss 750 ml. After pancreatic head resection with duodenal
preserving,choledochojejunalanastomosisandRouxenyreconstructionwasperformed.Oralfeedingresumed
onpostoperativeday510withoutcomplications.Abdominalpainwassignificantlyreducedaftertheoperation.
Thepatienthashadnormalbloodglucoselevelssincethesurgery.The patient had a very good recovery and
was discharged on the 15th post-operative day. Result of the histopathological of the mass is solid cystic
neoplasms. Thepublishedexperienceunderlineslowpostoperativemorbidityandmortality.
Conclusion
The most frequent pancreatic benign lesions are cystic neoplasms and neuro endocrine tumors, detected in 2-3%
of the adult population using the standardized application of high-resolution imaging techniques. Benign
tumorous lesions are increasingly detected fortuitously in asymptomatic patients. As a result of the preservation
of the duodenum, the endocrine function of the pancreas is maintained after DPPHR. The operations were
successfully performed.
Keyword : Giantfibroadenoma,Breast Reduction