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Bilateral Diffuse Pseudoangiomatous Stromal Hyperplasia Necessitating Mastectomy
V Morgan Jones1, Ashley Cairns1, Jennifer Miller-Ocuin1
112279Wake Forest University, Department of Surgery, Winston-Salem, NC, USA.
The American Surgeon
|April 18, 2022
Summary
Pseudoangiomatous stromal hyperplasia (PASH) is a rare benign breast condition. Unusual cases in adolescents and premenopausal women required mastectomy, highlighting PASH
Area of Science:
- Breast pathology
- Surgical oncology
- Radiology
Background:
- Pseudoangiomatous stromal hyperplasia (PASH) is an uncommon benign breast lesion.
- It is often mistaken for fibroadenoma due to similar radiographic appearance.
- Histopathology shows a dense fibrous stroma with spindle cells forming slit-like spaces.
Purpose of the Study:
- To present two unusual cases of PASH with atypical presentations.
- To highlight the variable clinical presentation of PASH.
- To review current management strategies for PASH.
Main Methods:
- Case report of two patients with PASH.
- Review of clinical presentation, imaging, and histopathology.
- Discussion of management options.
Main Results:
- An adolescent patient presented with rapid onset bilateral PASH.
- A premenopausal patient had bilateral, diffuse, recurrent PASH.
- Both patients required mastectomy due to the extent and recurrence of the disease.
Conclusions:
- PASH can present atypically, even in adolescents.
- Recurrent and extensive PASH may necessitate surgical intervention.
- Management should be individualized based on presentation and disease behavior.
