Gigantomastia complicating mirror syndrome in pregnancy.

Background: Gigantomastia is a rare and dangerous condition in pregnancy. Although improvement after delivery is likely, postpartum aggravation is possible. To date, various pharmacological approaches have been tried, with only marginal effectiveness. Surgical intervention is often necessary.

Case: A young woman presented at 32 weeks' gestation with mirror syndrome and gigantomastia. Two years earlier she had had reduction mammoplasty by free nipple transplant. She delivered by cesarean. Rapid postpartum progression of gigantomastia led to breast necrosis and sepsis. The clinical course was complicated by acute respiratory distress syndrome and renal failure. Emergent bilateral simple mastectomy was performed, with subsequent clinical improvement.

Conclusion: When this devastating condition occurs in pregnancy or postpartum, urgent surgical intervention may prevent potentially fatal complications.