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CC BY-NC-ND 4.0 · Arch Plast Surg 2022; 49(03): 369-372
DOI: 10.1055/s-0042-1748651
Breast/Trunk
Case Report

Gigantomastia as a Cause of Pulmonary Hypertension

Authors

  • Juan Pablo Castillo

    1   Facultad de Ciencias de la Salud, Grupo de investigación PLASTICUV Cali, Universidad del Valle, Cali, Colombia

  • Ana María Robledo

    1   Facultad de Ciencias de la Salud, Grupo de investigación PLASTICUV Cali, Universidad del Valle, Cali, Colombia
    2   Plastic Surgery Service, Hospital Universitario del Valle, Cali, Colombia

  • Laura Torres-Canchala

    3   Facultad de Ciencias de la Salud, Universidad Icesi, Cali, Colombia

  • Lady Roa-Saldarriaga

    1   Facultad de Ciencias de la Salud, Grupo de investigación PLASTICUV Cali, Universidad del Valle, Cali, Colombia
    2   Plastic Surgery Service, Hospital Universitario del Valle, Cali, Colombia
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Abstract

Reduction mammaplasty is the gold standard treatment for gigantomastia. We report one female patient with juvenile gigantomastia associated with severe pulmonary hypertension where her pulmonary pressure decreased significantly after the surgery, improving her quality of life. A 22-year-old female patient with gigantomastia since 10 years old, tricuspid regurgitation, and pulmonary thromboembolism antecedent was admitted to the emergency department. Her oxygen saturation was 89%. Acute heart failure management was initiated. An echocardiogram reported left ventricle ejection fraction (LVEF) of 70% with severe right heart dilation, contractile dysfunction, and arterial pulmonary pressure (PASP) of 110 mm Hg. A multidisciplinary team considered gigantomastia could generate a restrictive pattern, so a Thorek reduction mammoplasty with Wise pattern was performed. Presurgical measurements were: sternal notch to nipple-areola complex, right 59 cm, left 56 cm. Three days after surgery, the patient could breathe without oxygen support. In the outpatient follow-up, patient referred reduction of her respiratory symptoms and marked improvement in her quality of life. Six months after surgery, a control echocardiogram showed a LVEF of 62% and PASP of 85 mm Hg. Pulmonary hypertension may be present in patients with gigantomastia. Reduction mammoplasty may be a feasible alternative to improve the cardiac signs and symptoms in patients with medical refractory management.

Keywords

gigantomastia - mammoplasty reduction - pulmonary hypertension

Authors Contributions

J.P.C. and A.M.R. conceived the study, designed the study, and obtained ethics approval. J.P.C. and L.R.S. were involved in all aspects of the paper generation and revised each draft and coordinated all coauthors' activities. L.R.S. collected all the data. J.P.C., L.R.S., and L.T.C. wrote the different versions. L.R.S. also prepared the figures. All authors provided critical input into all aspects of the design and execution of the study and participated in all phases of the study.


Patient Consent

Informed consent was obtained from all individual participants included in the study.




Publication History

Article published online:
27 May 2022

© 2022. The Korean Society of Plastic and Reconstructive Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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