Gestational macromastia complicating pregnancy: A case report of unusual bilateral giant breasts in a patient who had no such problem in her previous pregnancies.

Key Clinical Message: Gestational macromastia is a rare disorder involving excessive breast tissue enlargement during pregnancy, potentially threatening the fetus and the mother. Our patient's previous pregnancies were more physiological, without any associated symptoms.

Abstract: Moderate bilateral enlargement of the breasts is a normal finding during pregnancy and lactation. Occasionally, there is a continuity from this physiological hypertrophy to massive breast hyperplasia or gigantomastia, causing complications that threaten the wellbeing of the fetus and the mother or raising alarm for a malignant disease. We present a case of a 28-year-old G3P2L2 with a gestational age of 29 weeks complaining of massive bilateral breast enlargement for 6 months, accompanied by a threatened abortion. The masses began gradually after conception and increased gradually over time. Notably, the breasts had been unremarkable in her two previous pregnancies. The breast ultrasonography and mammography findings pointed to a benign neoplasm. Histopathology of the lesions reported bilateral ductal hyperplasia. Conservative management and close follow-up were initiated. A cesarean section was performed due to cord prolapse, and a 1.3 kg male baby was extracted. Unfortunately, the neonate succumbed after 3 days due to apnea of prematurity. The patients' breast size subsided considerably with time. Unusually large tumors can cause alarm for other pathologies, such as breast cancer. The radiological tests should reassure the attending practitioner, and the histological examination should confirm the diagnosis. An understanding of the typical and atypical clinico-pathologic characteristics of breast lesions occurring in pregnancy and lactation is essential for appropriate patient care.