Case Report: An unusual case of prodigious Gigantomastia with macroprolactinemia and suspected autoimmune disease

Abstract Macroprolactinemia is characterized by most authors, as a benign condition with no clinical implications. Gigantomastia is the progressive breast enlargement, usually bilateral. Due to its rare presentation, fewer numbers of cases have been reported and its association has yet to be fully established. It is usually presented during puberty and pregnancy and its association with hyperprolactinemia, macroprolactinemia, and autoimmune diseases are reported but in small numbers. Its management is improving the clinical symptoms and it varies from case to case. A 47 female premenopausal with sudden onset of massive enlargement of the bilateral breast without galactorrhea over 18 months. She also noticed joint pain and swelling with her breast enlargement. She was referred to the breast clinic for managing breast-related symptoms associated with gigantomastia like mastalgia, neck and back pain, postural issues, and recurrent breast skin eruptions. Her serum investigation showed a Prolactin level of 1708 mIU/L and was also referred to an endocrinologist to rule out prolactinoma. She underwent bilateral breast reduction and a total of 12 KG breast tissue from both breasts were removed and she is under further investigation for autoimmune diseases. The present report followed this patient from diagnosis, surgical intervention, and establishing its association to any other condition. Even though gigantomastia is an erratic condition and is a rare entity, its timely investigation and association to other clinical conditions like hyperprolactinemia or macroprolactinemia and arthritis are essential in the efficacious management of this condition. Gigantomastia outside the reproductive age group needs further research.