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Giant pseudoangiomatous stromal hyperplasia presenting in the breast of a prepubertal child
Tarig Abdelrahman1, Philippa Young2, Olexandra Kozyar3
1Department of General Surgery, Abertawe Bro Morgannwg University Health Board, Bridgend, UK.
Insights
A rare, massive benign breast tumor (pseudoangiomatous stromal hyperplasia) was found in a 13-year-old girl. Surgical excision and breast reduction were successful, preserving future breast development.
Area of Science:
- Pediatric surgery
- Breast pathology
- Oncology
Background:
- Large benign breast lesions are exceptionally rare in pediatric patients.
- This case highlights the diagnostic and management challenges of significant breast masses in adolescents.
Observation:
- A 13-year-old girl presented with a 35 cm, 2.7 kg breast mass, concealed for 8 months.
- Initial suspicion of sarcoma was raised due to the mass's size.
Findings:
- Radiological evaluation suggested pseudoangiomatous stromal hyperplasia (PSH).
- Histological confirmation established the diagnosis of PSH.
- Surgical excision with reduction mammoplasty was performed, preserving developing breast tissue.
Implications:
- This is the largest documented case of PSH in a patient of this age.
- Successful surgical management preserved cosmetic appearance and allowed for healthy breast tissue development.
- The case underscores the importance of considering benign pathologies even in large pediatric breast masses.
Abstract:
Large benign lesions of the breasts are rare in children. We present a case of a 35 cm mass, weighing 2.7 kg in a 13-year-old girl with small developing breasts. Despite the enormity of the lesion, the patient managed to keep it concealed from her parents for 8 months. While initially suspicious of sarcoma a diagnosis of pseudoangiomatous stromal hyperplasia was suggested radiologically and confirmed histologically. Excision with reduction mammoplasty was performed, care taken not to disrupt the remaining breast tissue to facilitate future breast development. 18 months on, the cosmetic appearance of the breasts is good, with healthy underlying breast tissue developing. To the best of our knowledge this case is the largest documented breast tumour of this type in a patient of this age and illustrates the challenge of treating such tumours in the developing breast.
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