Synchronous Bilateral Breast Carcinoma: A Clinicopathological Report of a Rare Case with Treatment Challenges

Synchronous bilateral breast carcinoma (SBBC) is rare manifestation with an incidence ranging from 0.2% to 12%. The prognosis of the disease, its histopathological characteristics, and the molecular behaviour remain unclear. However, many studies have indicated independent chromosomal abnormalities from the two cancers that show an increase CXCR4 receptor expression with a high tendency of visceral metastasis. To date there are no standard protocols for treatment of SBBC and these pose challenges in interpreting survival data and recurrence. A 39-year-old female para 5+1, four alive presented with a 2-year history of a left breast lump and one-year history of a right breast lump. Both lumps were painless and progressively increased in size. The breasts show lumps at the upper outer quadrants measuring 7 x 6 and 6 x 5cm for left and right breast respectively, the overlying skin shows peud'orange. Biopsies confirmed SBBC with a discordant histology with triple-negative hormonal status. The patient had bilateral radical mastectomy and chemotherapy. We present a case of SBBC to re-emphasize the significance of screening for contralateral breast in patients who present with unilateral breast cancer. The standard treatment guideline is still lacking in the management of SBBC worldwide, therefore, multi-institutional prospective studies with long time follow-up of the patients are required for a better management of SBBC

Giant parotid pleomorphic adenoma in a Nigerian male

Pleomorphic adenoma (PA) is the most common benign salivary gland tumor, accounting for up to 60% of all tumors of the salivary gland and 75–80% of all parotid tumors. It has a slow but progressive growth pattern and if untreated can become greatly enlarged in size. However, giant PA is uncommon. We report a case of giant parotid PA of more than 10 years duration in a 60‑year‑old male Nigerian. A 60‑year‑old male patient with 10‑year history of painless, massive, and pedunculated swelling in the left side of lower face measuring 25 cm × 23 cm × 17 cm in dimension. Computerized tomographic scan and percutaneous fine needle aspiration cytology returned a preliminary diagnosis of PA. Superficial parotidectomy with facial nerve preservation via the transcervical approach was performed. The excised mass weighed 5.5 kg while the postoperative healing was satisfactory. Benign PAs may attain a giant size if left untreated. Socioeconomic problems are some of the reasons for late presentation. Adequate excision of the tumor sparing the facial nerve is possible but intraoperative and reactionary hemorrhage are likely complications.Keywords: Challenges, developing country, giant, parotid, pleomorphic adenoma, salivar

Gestational Gigantomastia: Report of a Rare Case and Literature Review

Background: Gestational gigantomastia is a rare disorder with unknown aetiology. It commonly occurs during the first and early second trimesters and mostly affects women during their second and third decades of life. The disease has been reported to be more common among Caucasians than Blacks and involves both breasts in 92% of cases. There are no standard treatment protocols for the disease, however, both medical use of bromocriptine and simple mastectomy have been applied. Case summary: We present a case of 32-year-old un-booked female, G8P7+0, 7 alive, who presented with bilateral breast enlargement with ulceration at 25 weeks’ gestation. The diagnosis was confirmed by tissue biopsy and simple mastectomy was done and the pregnancy was allowed to continue to term. Conclusion: This case report describes the first case of gestational gigantomastia in our environment and the seventh case reported in Africa to increase our awareness on how to diagnose and rule out other causes of bilateral massively enlarged breasts during pregnancy and the treatment options for this distressing clinical condition