Fast-Growing Pseudoangiomatous Stromal Hyperplasia of the Breast: Report of a Case

Abstract

Pseudoangiomatous stromal hyperplasia (PASH) is a rare type of benign mesenchymal proliferative disease of the breast. Histologically, it is composed of a proliferation of spindle cells with inter-anastomosing vascular-like arrangement in the interlobular or interductal stroma. Clinically, pseudoangiomatous stromal hyperplasia is usually found in premenopausal women as a discrete, painless mass, which is firm and movable. We report a case of pseudoangiomatous stromal hyperplasia of the breast, which mimicked a malignant mass in that it grew rapidly and ultrasonography showed a lobulating contoured heterogeneous echotexture.

Bilateral Diffuse Pseudoangiomatous Stromal Hyperplasia (PASH) Causing Gigantomastia in a 33-Year-Old Pregnant Woman: Case Report

“…Incidental PASH does not require any additional treatment and tumorous PASH is treated by local excision with clear margins. However, the very rare diffuse PASH with massive breast enlargement requires uni-or bilateral mastectomy as in our patient and other reported cases [3][4][5]. The risk of recurrence after surgical excision is up to 22% [6,12].…”

“…In very rare cases PASH presents as bilateral diffuse process leading to rapid breast enlargement without discrete nodular mass (diffuse PASH). Less than 200 cases of nodular PASH and less than 20 of rapidly growing diffuse PASH have been reported in the literature so far, to our knowledge, none of them in a pregnant woman [3][4][5].…”

Pseudoangiomatous stromal hyperplasia causing massive breast enlargement

“…To date, there has been only one reported case that suggested possible malignant transformation of a PASH lesion,16 and rare cases have been reported in PASH-associated ductal carcinoma in situ (DCIS) 8. PASH can co-exist with a malignant process, and any suspicious imaging features would warrant tissue sampling.…”

Mesenchymal tumours of the breast and their mimics: a review with approach to diagnosis

“…12,62 Patients may present with a palpable mass that is typically slow-growing, although occasional cases with rapid growth mimicking malignancy have been described. 64 The clinical and radiological impression may be of fibroadenoma.…”