Bilateral diffuse pseudoangiomatous stromal hyperplasia (PASH) causing gigantomastia in a 33-year-old pregnant woman: case report

Abstract

tologically a low-grade angiosarcoma. There are less than 200 cases of tumorous PASH and less than 20 of diffuse PASH reported so far. Here we present a case report of huge diffuse PASH, that is, to our knowledge, the first in a pregnant woman.

Pseudoangiomatous Stromal Hyperplasia (PASH) of the Breast: An Uncommon Finding in an Uncommon Patient

“…These interactions could increase the level of progesterone that could stimulate PASH growth. A hormonal etiology is also supported by the higher PASH prevalence in premenopausal woman (the majority of whom are actively taking oral contraceptive pills) [16], in 24% to 47% of men with gynecomastia [17] and by reported case of PASH in a transgender male during hormone therapy [18] or during pregnancy [19]. PASH affects pre-menopausal women or menopausal women in hormone replacement therapy (HRT).…”

Management of recurrent bilateral multifocal pseudoangiomatous stromal hyperplasia (PASH)

“…10 In support of this theory, there have been a few case reports of rapid bilateral breast enlargement associated with PASH during pregnancies, most likely in response to rising hormone levels. 11,12 The histologic features of PASH has also been shown to resemble those of intralobular stroma during the luteal phase of the menstrual cycle, when progesterone secretion is high. 13 Despite its hyperplastic nature, the condition is not associated with increased risk of breast malignancy.…”

Rapidly-growing pseudoangiomatous stroma hyperplasia (PASH) causing bilateral gigantomastia in a 15-year-old patient

“…Bilateral diffuse multiple tumors leading to massive bilateral breast enlargement are rare. Other reports have been published presenting patients with bilateral gigantomastia due to PASH [5][6][7][8][9], all reporting bilateral breast enlargement, with palpable masses in some cases. However, Fig.…”

“…Until today, no recurrence has been observed during follow-up. In the other cases presenting patients with bilateral gigantomastia due to PASH, mastectomies were performed, except for two where in one patient a breast reduction was performed and in the other one the lesions were observed [5][6][7][8][9]. No recurrence was reported.…”