Introduction: Fibroadenomas are the most common benign tumors of the breast; however, their presentation as multiple and bilateral lesions is uncommon, particularly in young patients. Coexistence with a benign phyllodes tumor is exceptional and poses diagnostic and therapeutic challenges. Case presentation: We report the case of an 18-year-old woman with intellectual disability who presented with multiple painful bilateral breast masses of eight months’ duration. Physical examination revealed approximately ten bilateral breast nodules. Breast ultrasonography demonstrated multiple oval lesions with circumscribed margins, classified as BI-RADS 3. Due to the multiplicity, size of the lesions, and associated symptoms, surgical management was chosen without prior biopsy. Complete resection of the lesions was performed through a single circumferential periareolar incision using the round-block technique. Histopathological examination revealed multiple bilateral pericanalicular fibroadenomas and three benign phyllodes tumors with negative surgical margins. Postoperative evolution was favorable, with complete resolution of pain and no complications. Clinical and imaging follow-up at 3 and 6 months showed no recurrence. Conclusion: This case illustrates an uncommon presentation of multiple bilateral fibroadenomas associated with benign phyllodes tumors in a young patient. Conservative surgical management using the round-block technique allowed adequate resection with favorable clinical and aesthetic outcomes. The importance of an individualized diagnostic approach and close follow-up in rare presentations of fibroepithelial breast tumors is emphasized.
Córdova et al. (Fri,) studied this question.