Gestational Gigantomastia in a 37-Year-Old Woman: Managed Successfully by Multidisciplinary Approach

Abstract

Gestational gigantomastia (GG) is an extremely rare condition characterized by excessive breast enlargement during pregnancy and may lead to serious maternal morbidity. Due to its rarity, standardized management guidelines are lacking, particularly in resource-limited settings. To the best of our knowledge, this is the first reported case of gestational gigantomastia from Bangladesh and contributes valuable regional evidence to guide clinical and surgical decision-making. A 37-year-old woman at 33+ weeks of gestation presented with massive bilateral breast enlargement over seven months, complicated by respiratory distress and an infected ulcer wound. Right and left breasts were weighed approximately 15kg and 13 kg respectively, with associated skin ulceration and accessory breast tissue. Imaging revealed diffuse edematous breast parenchyma without malignancy, and core biopsy for histopathology confirmed a benign proliferative lesion. After multidisciplinary consultation, pregnancy was terminated via lower-segment cesarean section. Following delivery and clinical stabilization, the patient was treated conservatively with the dopamine agonist cabergoline. Post-treatment, the patient demonstrated a significant reduction in breast size with resolution of respiratory distress. She was discharged in stable condition with a plan for delayed reduction mammoplasty, which she later declined. At follow-up, breast volume had decreased, although residual skin laxity remained. Early recognition of gestational gigantomastia is essential, particularly when rapid breast enlargement leads to systemic complications.