Gigantomastia due to retromammary lipoma: An aesthetic management.

INTRODUCTION: A "giant" lipoma is defined as a tumor having dimensions greater than 10 cm. Giant lipomas are rare and giant breast lipomas are exceptionally uncommon. Only six cases have been described in world literature till date. Herein we describe a case of giant breast lipoma and discuss its surgical management.

CASE REPORT: A 43-year-old lady presented with left sided unilateral gigantomastia. Clinical examination, radiology and histopathology diagnosed lipoma. Excision of the tumor was planned, together with correction of the breast deformity by reduction mammoplasty using McKissok technique. A tumor measuring 19 cm × 16 cm × 10 cm and weighing 1647 grams was removed. The nipple areola complex was set by infolding of the vertical pedicles and the lateral and medial flaps were approximated to create the final breast contour. The patient is doing well on follow up.

DISCUSSION: Giant lipomas are rare and of them, giant breast lipomas are extremely uncommon. They can grow to immense proportions and cause significant aesthetic and functional problems. The treatment is excision. But reconstruction of the breast is almost always necessary to achieve a symmetric breast in terms of volume, shape, projection and nipple areola complex symmetry compared to the normal opposite breast. Few authors have used various mammoplasty techniques for reconstruction of the breast after giant lipoma excision. Our case has the following unique features: (i) It is the third largest breast lipoma described in the literature till date, weighing 1647 grams; (ii) The Mckissock technique has been used for parenchymal reshaping which has not been previously described for giant breast lipoma.

CONCLUSION: This case demonstrates that reduction mammoplasty after giant lipoma removal is highly rewarding, resulting in a smaller-sized breast that is aesthetically more pleasing, has better symmetry with the contralateral breast, and provides relief from functional mass deficit.