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Pseudoangiomatous stromal hyperplasia (PASH) is a benign mesenchymal proliferative lesion of the breast. In 2005, only 109 cases have been reported since its initial description in 1986 by Vuitch et al. when it presented in one patient as a palpable breast mass. We retrospectively reviewed data from 2020 to 2023 of patients diagnosed with PASH by surgical excision. Our 13 cases represent one of the most numerous reported from a single institution. All histologic specimens were examined by a single pathologist. All patients had breast masses on imaging or were clinically evident. Eleven of the patients (84.6%) were diagnosed by surgical excision, whilst only two (15.4%) were diagnosed by core needle biopsy. Imaging revealed no strongly distinctive features for PASH. The age of the patients ranged from 25 to 68 years. All but one of the women were premenopausal at the time of diagnosis. This study suggests that PASH is a lesion whose diagnosis is often incidental and the recommended treatment is more commonly surgical. [ABSTRACT FROM AUTHOR]

Pseudoangiomatous stromal hyperplasia (PASH) is a benign interstitial hyperplasia of the breast that usually occurs in premenopausal or perimenopausal women. It is usually characterized by localized lesions or clear boundary masses, and diffuse double breast enlargement is rare. PASH is considered a hormone-dependent disease that is commonly progesterone related. There are no imaging characteristics, and both benign and suspicious malignant signs can be seen. The definitive diagnosis of PASH depends on a pathological diagnosis, and it is necessary to be vigilant in distinguishing between benign and malignant tumors with similar breast histopathology. Here, we report the case of a 23-year-old multipara patient with bilateral diffuse pseudoangiomatous stromal hyperplasia of the breast during pregnancy who presented with macromastia and reviewed the literature to further understand the clinical features, pathological diagnosis, differential diagnosis, treatment and prognosis of pseudoangiomatous stromal hyperplasia of the breast. [ABSTRACT FROM AUTHOR]

Gigantomastia is a rare condition characterized by excessive hypertrophy of the connective tissue of the breast, which can cause physical and emotional distress. Surgical intervention is crucial for improving patients’ quality of life; however, it is challenging to balance minimizing the risk of recurrence and maximizing favorable aesthetic outcomes. This study documents the successful management of three rare cases of bilateral gigantomastia resulting from benign tumors. These cases included rapidly growing bilateral diffuse tumorous pseudoangiomatous stromal hyperplasia (PASH) and bilateral juvenile giant fibroadenoma, with no long-term recurrence observed. We discuss the diagnostic challenges and management considerations for gigantomastia, with a focus on reviewing PASH and its differential diagnosis. The findings offer valuable insights into the successful management of diverse gigantomastia cases caused by benign tumors, potentially aiding clinicians in making more informed decisions regarding optimal patient care.

Aim: The study was conducted to systematically analyze the recent peer-reviewed literature related to tumoral pseudoangiomatous stromal hyperplasia (PASH) in males. Materials and methods: Articles published in peer-reviewed journals of repute from 2012 to 2023 were evaluated for eight variables: 1) the age of the patient, 2) clinical presentation, 3) laterality (unilateral or bilateral), 4) associated breast disorder, 5) the presence of systemic co-morbidity, 6) imaging modalities aiding diagnosis, 7) treatment, and 8) recurrence. Results: There were 10 patients ranging in age from 1 year to 67 years (mean: 34.5 years). In 8 cases (80%), there were breast lumps; in 2 cases (20%), there were axillary lumps at presentation. Pain was not a prominent symptom. Six patients (60%) had another breast disorder at presentation and 3 (30%) had significant systemic co-morbidities, including diabetes and renal insufficiency. The greatest dimension of the lumps ranged from 2 cm to 12 cm, with 80% of the lumps being below 5 cm in size. Imaging modalities utilized in evaluation included breast ultrasound (USG), mammograms, computerized tomography (CT), and magnetic resonance imaging (MRI). All the cases were treated surgically, and the final diagnosis was made only after the analysis of the surgical specimen. Recurrence was recorded in 2 (20%) cases. Conclusions: Tumoral PASH is a benign myofibroblastic proliferation disorder rarely reported in males. This condition should be considered a differential diagnosis of breast or axillary lumps, and an evaluation should be initiated accordingly. The recommended course of treatment is adequate surgical excision with regular clinical and radiological follow-up. [ABSTRACT FROM AUTHOR]

Pseudoangiomatous stromal hyperplasia (PASH) is a benign entity of the breast and typically found incidentally or as a palpable mass. It usually affects women in the reproductive age group. In men, it is associated with gynecomastia. While the exact etiology is unknown, PASH is considered hormonally responsive. The mammography and ultrasonography findings are nonspecific. Grossly, PASH is a well-circumscribed, firm, rubbery mass with solid, homogenous, gray–white cut surface. On histologic examination, it is characterized by the presence of open slit-like spaces in dense collagenous stroma. The spindle cells express progesterone receptors and are positive for vimentin, actin, and CD34. PASH lesions should be surgically excised if increasing in size or associated with symptoms, also in cases of suspicious imaging findings or other lesions are synchronously diagnosed that require excision. In other small incidentally detected asymptomatic cases observation with clinicoradiological follow-up can be considered. It is associated with a good prognosis with no increased risk to develop breast cancer. Hence, the operating surgeon and pathologist should be aware of this not so uncommon entity so that patients are not subjected to unnecessary excision and subsequent physical and mental morbidity associated with it. In this article, we present a case report and also provide a brief review of the sparse literature on PASH, discussing clinical presentation, etiology and pathogenesis, radiopathological features, differential diagnosis, and the implications for further patient management and prognosis. [ABSTRACT FROM AUTHOR]

Aims: Juvenile fibroadenomas (JFA) are biphasic fibroepithelial lesions (FEL) usually occurring in adolescent female patients. Giant (G) JFA, like other FEL, may exhibit prominent pseudoangiomatous stromal hyperplasia (PASH)‐like change. We sought to determine clinicopathological and molecular characteristics of GJFA with and without PASH. Methods and results: Archives were searched for cases of GJFA (1985–2020). All were stained for androgen receptor (AR), beta‐catenin, CD34 and progesterone receptor (PR). Cases were sequenced using a custom 16‐gene panel – MED12 (exons 1 and 2), TERT promoter (–124C>T and –146Ctable>T), SETD2, KMT2D, RARA (exons 5–9), FLNA, NF1, PIK3CA (exons 10, 11 and 21), EGFR, RB1, BCOR, TP53, PTEN, ERBB4, IGF1R and MAP3K1. Twenty‐seven GJFA from 21 female patients aged 10.1–25.2 years were identified. Size ranged from 5.2 to 21 cm. Two patients had multiple, bilateral and later recurrent GJFA. Thirteen (48%) cases showed prominent PASH‐like stroma. All were positive for stromal CD34, negative for AR and beta‐catenin and one case showed focal PR expression. Sequencing showed MAP3K1 and SETD2 mutations in 17 samples, with KMT2D, TP53 and BCOR aberrations in 10 (45%), 10 (45%) and seven (32%) cases, respectively. Tumours with a PASH‐like pattern had higher prevalence of SETD2 (P = 0.004) and TP53 (P = 0.029) mutations, while those without PASH had more RB1 mutations (P = 0.043). MED12 mutation was identified in one case. TERT promoter mutation was observed in four (18%), including two recurrences. Conclusions: Gene mutations along more advanced phases of the proposed FEL pathogenetic pathway in GJFA are unusual, and suggest a mechanism for more aggressive growth in these tumours. [ABSTRACT FROM AUTHOR]

Gigantomastia is a rare pathologic condition characterized by an excessive and abnormal breast hypertrophy. To date, there is no exact definition or classification of this disease. Pathogenesis still unclear. The purpose of this article is to present a case of extreme and disabling gigantomastia caused by pseudoangiomatous stromal hyperplasia, one of the rarest etiology of gigantomastia. [ABSTRACT FROM AUTHOR]

Pseudoangiomatous stromal hyperplasia (PASH) is a benign mesenchymal tumor-like lesion of the breast. It is commonly seen as incidental background changes of the intralobular stroma in biopsy specimens performed for other breast lesions. Less frequently, it presents as a nodular form that has a benign morphology on imaging, mimicking fibroadenoma or as a diffuse form causing progressive massive gigantomastia. Diagnosis is established by biopsy. Knowledge of the imaging appearance of PASH not only facilitates proper assessment of radiopathological correlation but also helps in deciding further management of these lesions. Occasionally, nodular PASH may have a suspicious appearance on imaging wherein excision biopsy is indicated to exclude a coexisting carcinoma.

This case report describes the occurrence of a rapidly enlarging pseudoangiomatous stromal hyperplasia (PASH) tumor in a 20-year-old male patient. The diagnosis was made via tomosynthesis and ultrasound-guided biopsy with pathological correlation consistent with PASH. The patient's case was discussed, and he was recommended to undergo surgical resection of the mass to alleviate symptoms due to its large size. Surgical pathology confirmed the original diagnosis and the patient had an uncomplicated postoperative course. Here, we exhibit our imaging findings; review classic presentations of PASH on mammography, ultrasound, and MRI; and discuss histological characteristics of this benign entity.

Macromastia in adolescents is both physically and psychologically debilitating during a period in life when individuals are particularly vulnerable to peer pressure and social norms. Early recognition and intervention by both pediatricians and surgeons are critical to avoid unnecessary suffering. While reduction mammaplasty is the gold standard for the management of symptomatic macromastia in adults, the management of macromastia in pediatric patients remains controversial. In particular, there is great discussion regarding the timing of reconstructive breast surgery in pediatric patients. A comprehensive review of the literature was performed to identify all articles related to macromastia in patients ≤16 years of age, the age at which full development is typically achieved in the United States. The etiologies of pediatric macromastia, approaches to management, and outcomes are summarized herein. Pathological breast hypertrophy in pediatric patients is a rare finding and may occur secondary to juvenile hypertrophy of the breast (JHB) and pseudoangiomatous stromal hyperplasia (PASH). While medical management of these pathologies has been attempted with varying success, reduction mammaplasty is safe and effective in pediatric patients. There are, however, a number of pediatric-specific considerations that must be taken into account prior to surgery. We provide an algorithm for approaching pediatric macromastia. [ABSTRACT FROM AUTHOR]

BACKGROUND: Pseudoangiomatous stromal hyperplasia is a rare benign breast stromal proliferative lesion of the breast. Clinical presentation ranges from rapidly growing mass to incidental identification in routine screening. This difference in manifestation and its rarity makes it difficult to be a standard treatment protocol. Therefore, we aimed to share our clinical experience in Pseudoangiomatous stromal hyperplasia. METHODS: The files of patients who underwent core biopsy or surgical excision due to a breast mass and resulted in pseudoangiomatous stromal hyperplasia between January 2013 and December 2021 were included in the study. RESULTS: 17 patients with a median age of 37 (22–68) were found Pseudoangiomatous stromal hyperplasia confirmed by surgical excision or core biopsy. Chosen treatment option was observation in 8 patients (47.1%), while surgical excision was used in 9 (52.9%) patients. The mean follow-up period was 55.24 ± 26.72 (13–102) months. None of the patients observed the Malignant transformation during the follow-up period. CONCLUSION: For Pseudoangiomatous Stromal Hyperplasia of the breast, surgical excision with clean margins or close follow-up after diagnosis confirmation by tissue biopsy is sufficient. Pseudoangiomatous Stromal Hyperplasia is not a risk factor for developing breast cancer. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study were to determine the relationship of pseudoangiomatous stromal hyperplasia (PASH)-like appearance in invasive breast carcinomas (IBCs) with PASH foci in the non-tumoral breast parenchyma as well as axillary lymph node involvement. Methods: In this study, 200 consecutive cases with IBC were re-examined. Cases with and without PASH-like appearance in IBC were determined. Each case was assessed regarding the presence of accompanying PASH foci (CD34+, CD31-) in the non-tumoral areas in addition to other clinicopathological parameters. Results: PASH-like appearance within the IBC was present in 22 of the 200 cases (11%) and absent in 178 (89%). The presence of PASH foci in the non-tumoral breast parenchyma was significantly more common in IBC with PASH-like appearance compared to the group without such areas. However, there was no significant difference between the groups regarding other clinicopathological parameters (age, tumor size, nuclear and histological grade, Estrogen receptor/Progesterone receptor status, HER2 status, and Ki-67 proliferation index), lymphovascular invasion (LVI), and axillary lymph node involvement. There was no significant difference between the two groups regarding the histopathological findings observed in the non-tumoral areas. Conclusion: PASH-like appearance within IBC was found to be associated with higher rate of PASH foci in the non-tumoral breast parenchyma. However, such cases do not show a difference as regards LVI and axillary lymph node metastasis. [ABSTRACT FROM AUTHOR]

Pseudoangiomatous stromal hyperplasia (PASH) is a benign mesenchymal tumor-like lesion of the breast. It is commonly seen as incidental background changes of the intralobular stroma in biopsy specimens performed for other breast lesions. Less frequently, it presents as a nodular form that has a benign morphology on imaging, mimicking fibroadenoma or as a diffuse form causing progressive massive gigantomastia. Diagnosis is established by biopsy. Knowledge of the imaging appearance of PASH not only facilitates proper assessment of radiopathological correlation but also helps in deciding further management of these lesions. Occasionally, nodular PASH may have a suspicious appearance on imaging wherein excision biopsy is indicated to exclude a coexisting carcinoma. [ABSTRACT FROM AUTHOR]

Pseudoangiomatous stromal hyperplasia (PASH) is a rare benign breast disorder that typically presents as small foci. Estrogen-treated elderly women are most affected. Histologic proof is needed because PASH can clinically and radiologically mimic fibroadenoma. Surgical excision is best for well-defined lesions, but tamoxifen is effective in diffuse situations. PASH diagnosis and treatment are discussed in this presentation to improve patient care. A 30-year-old female has cystic breast disease without any hormonal treatment, applied with palpable masses in both breasts. Ultrasound and MRI scans detected many suspicious masses, highlighting the potential of a nearly 4 cm phyllodes tumor in left breast. The biopsy result revealed the presence of fibroadenoma on the right side and phyllodes on the left without any mitotic activity, which changed the course of treatment. Bilateral skin-sparing mastectomy with sentinel lymph node biopsy and immediate breast reconstruction using implants was recommended. The treatment strategies for PASH vary from conservative to surgical procedures; total removal of the tumor to mastectomy. Mastectomy followed by reconstructive surgery may be recommended in cases of diffuse lesions. Alternatively, tamoxifen can be used as a medical treatment to manage the condition. The post-treatment recurrence rate varies from 15% to 22%, and there have been no reported cases of malignant transformation in the literature. [ABSTRACT FROM AUTHOR]

Pseudoangiomatous stromal hyperplasia (PASH) is a rare benign mesenchymal proliferation of the breast with unclear etiology. It is diagnosed in a wide spectrum from incidental microscopic findings to palpable breast mass. Diagnosis is generally made in the premenopausal age group. PASH cases seen in adolescents reported in the literature are very rare and none of them has mentioned the radiologic features in detail. In this case report, we present a 12-year-old patient with giant (150x100x127 mm in size) PASH in her right breast, giving emphasis to the findings of the ultrasonography and magnetic resonance imaging, including contrast-enhanced dynamic and diffusion-weighted imaging sequences. To the best of our knowledge, the present case is the second biggest giant PASH seen in the adolescent age.

Pseudoangiomatous stromal hyperplasia (PASH) is a benign but rare mesenchymal proliferation of the mammary stroma, characterized by pseudovascular spaces within a hyperplastic matrix. PASH can be classified as either non-tumor-forming or tumor-forming. The non-tumor-forming type is an infiltrative and clinically undetectable mass, incidentally found in approximately a quarter of breast biopsies. Tumor-forming PASH, however, is a rare neoplasm of the breast parenchyma, with its occurrence in extra-mammary sites, such as the axilla, reported in less than a dozen cases. We report the case of a 38-year-old female who presented with bilateral, progressively enlarging axillary growths. Following mammography, which classified the masses as breast imaging-reporting and data system (BI-RADS) 2, the patient underwent bilateral subcutaneous mastectomy for the excision of the axillary ectopic breast tissue. Final pathology revealed PASH with complete excision. This report highlights the importance of including PASH as a differential diagnosis for any mass presenting along the mammary ridge. Diagnosing and properly managing this rare neoplasm require a nuanced examination integrating clinical, radiological, and histopathological perspectives., Competing Interests: Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Natoli et al.)

Pseudoangiomatous stromal hyperplasia (PASH) is a rare, benign breast lesion characterized by collagen proliferation, often identified as an incidental microscopic finding. Clinically, it may present as a palpable, well-defined breast mass or, in rare instances, as a diffuse, bilateral process leading to significant breast enlargement. We herein report a case of extensive diffuse PASH with short-term recurrence following lesion resection at another hospital. Because of the severity of symptoms, the patient underwent bilateral mastectomy at our facility. This article reviews the clinical, radiologic, and pathologic features of PASH and emphasizes the importance of an accurate preoperative imaging diagnosis for guiding appropriate treatment., Competing Interests: Declaration of conflicting interestThe authors declare that there is no conflict of interest.

Pseudoangiomatous stromal hyperplasia is a benign proliferative mesenchymal lesion of the breast. To date, only a few cases of axillary pseudoangiomatous stromal hyperplasia with imaging findings have been reported in the literature. Herein, we report a rare case of pseudoangiomatous stromal hyperplasia in both axillae in a previously healthy 46‐year‐old woman and describe the imaging findings, including ultrasonography and computed tomography findings. [ABSTRACT FROM AUTHOR]

Pseudoangiomatous stromal hyperplasia (PASH) is a rare breast stromal lesion that typically manifests clinically as a palpable unilateral, painless lump that is freely movable and has a rubbery or firm consistency. The diagnosis can be confirmed by a core needle biopsy (CNB) or surgical excision. Treatment options include medical treatment with hormonal management for asymptomatic patients or local excision and breast reduction in rare cases. We reported the case of a 24-year-old woman with a history of taking contraceptive pills for about a year. Examination revealed extremely enlarged, sore, and swollen breasts, particularly the right side, marking her third PASH relapse. The patient underwent a surgical skin-reducing mastectomy (SRM) using a novel technique with an immediate prepectoral implant covered by a dermal flap to reconstruct the breast shape due to the large PASH lesions and aiming for optimal cosmetic outcomes. The procedure was complication-free with no recurrence after 18 months of follow-up. Mastectomy followed by immediate implantation offers benefits such as prompt restoration of breast shape with fewer surgeries. This case report highlights the successful use of immediate implantation in reconstructing large recurrent benign breast diseases. The outcomes indicate that immediate implantation shows promise as a suitable choice for carefully selected patients managing large, relapsing bilateral benign breast diseases. However, due to common complications such as infection and implant loss, it is not generally recommended for benign lesions. The decision should be made on a case-by-case basis, considering the size, recurrence, and individual suitability. • PASH typically grows slowly, instances of rapid growth are rare. • Symptomatic and recurrent cases can benefit from surgical interventions such as breast reduction. • SRM improves aesthetic outcomes and psychological well-being. • Mastectomy with immediate reconstruction is promising for managing recurrent huge PASH. [ABSTRACT FROM AUTHOR]

Pseudoangiomatous stromal hyperplasia (PASH) is a rare benign breast lesion that is is extremely rare in children and adolescents. A 13-year-old girl was admitted to our clinic with a giant mass in the left breast for 3 months. Physical examination findings of the patient were normal except for the mass in the breast. The mass was removed totally, and its pathological diagnosis was pseudoangiomatous stromal hyperplasia. The patient has been followed up for 6 months without disease. [ABSTRACT FROM AUTHOR]

Tumorous pseudoangiomatous stromal hyperplasia (PASH) of mammary gland is a rare benign lesion caused by the hyperplasia of breast interstitial myofibroblast. Columnar cell lesions (CCLs) can be observed in close association with PASH-like stroma. There are extremely few reports of PASH with CCLs in the literature to date. In this study, we performed a detailed morphological and immunohistochemical analysis of 2 cases of this rare phenomenon. Two patients, who were 29 and 22 years of age, were referred to our hospital with masses presenting as rapidly enlarging nodules in the left axilla or in the left breast on physical examination, which were suspected to be malignancy or fibroadenomas, respectively. Interestingly, immunohistochemistry showed that both our cases involved young women who were negative for hormone receptors. More remarkably, case 1 showed new foci arising in the axillary region a very short time after mastectomy. The new foci may have been due to recurrence of the excised PASH or the emergence of new PASH from uncertain causes. The etiology and mechanism of the recurrence of PASH is currently unknown.Therefore, complete surgical resection and long-term postoperative follow-up are important.

Pseudoangiomatous stromal hyperplasia is a benign proliferative lesion of the breast tissue that typically affects women in the reproductive age. Pseudoangiomatous stromal hyperplasia usually presents as a localized, painless, firm mass or as a diffuse thickened area of the breast. Rarely, it can arise along the embryonic milk line, up to the anogenital region, where it simulates angiosarcomas. Awareness of this uncommon condition is important in order to avoid unnecessary aggressive excisional surgical procedures. For this purpose, we present a case of nodular pseudoangiomatous stromal hyperplasia arising in the vulva in a patient with recurrent pseudoangiomatous stromal hyperplasia of the breast.

Pseudoangiomatous stromal hyperplasia (PASH) is a rare benign mesenchymal proliferation of the breast with unclear etiology. It is diagnosed in a wide spectrum from incidental microscopic findings to palpable breast mass. Diagnosis is generally made in the premenopausal age group. PASH cases seen in adolescents reported in the literature are very rare and none of them has mentioned the radiologic features in detail. In this case report, we present a 12-year-old patient with giant (150x100x127 mm in size) PASH in her right breast, giving emphasis to the findings of the ultrasonography and magnetic resonance imaging, including contrast-enhanced dynamic and diffusion-weighted imaging sequences. To the best of our knowledge, the present case is the second biggest giant PASH seen in the adolescent age. [ABSTRACT FROM AUTHOR]

Pseudoangiomatous stromal hyperplasia (PASH), a rare, noncancerous lesion, is often an incidental finding on magnetic resonance imaging (MRI)‐guided biopsy analysis of other breast lesions. We sought to describe the characteristics of PASH on MRI and identify the extent to which these characteristics are correlated with the amount of PASH in the pathology specimens. We identified 69 patients who underwent MRI‐guided biopsies yielding a final pathological diagnosis of PASH between 2008 and 2015. We analyzed pre‐biopsy MRI scans to document the appearance of the lesions of interest. All biopsy samples were classified as having ≤50% PASH or ≥51% PASH present on the pathological specimen. On MRI, 9 lesions (13%) appeared as foci, 19 (28%) appeared as masses with either washout or persistent kinetics, and 41 (59%) appeared as regions of nonmass enhancement. Of this latter group, 33 lesions (80%) showed persistent kinetic features. Masses, foci, and regions of nonmass enhancement did not significantly correlate with the percentage of PASH present in the biopsy specimens (P ≥.05). Our findings suggest that PASH has a wide‐ranging appearance on MRI but most commonly appears as a region of nonmass enhancement with persistent kinetic features. Our finding that most specimens had ≤50% PASH supports the notion that PASH is usually an incidental finding. We did not identify a definitive imaging characteristic that reliably identifies PASH. [ABSTRACT FROM AUTHOR]

Pseudoangiomatous stromal hyperplasia is a rare benign breast neoplasm. The exact prevalence of this condition is unknown. According to the literature, it is an extremely uncommon disease in adolescent patients, especially when presenting with a giant mass causing significant breast enlargement. The clinical management of pseudoangiomatous stromal hyperplasia continues to be a controversial issue, however, surgical treatment remains the most accepted when there is an important mass-effect. We report the case of a 12-year-old premenarchal female, referred to our hospital with complaints of a rapidly enlarging left breast mass, of 12cm in diameter, causing a significant breast asymmetry. The ultrasonographic findings were unspecific. The core needle biopsy of the mass was consistent with pseudoangiomatous stromal hyperplasia, consequently, successful surgical excision was performed. This case illustrates a particularly unusual presentation of pseudoangiomatous stromal hyperplasia in a premenarchal adolescent patient, that should be taken into consideration in the differential diagnosis of abrupt breast enlargement. [ABSTRACT FROM AUTHOR]

Breast asymmetry can be congenital or developmental, however a tumorous growth may be the cause of this condition after puberty. A 19-year-old female presented with a slowly developing breast asymmetry pre-operatively diagnosed as Pseudoangiomatous Stromal Hyperplasia (PASH). The patient underwent tumour excision with breast gland remodelling. Postoperative course was uneventful. [ABSTRACT FROM AUTHOR]

Pseudoangiomatous stromal hyperplasia (PASH) is a benign hyperplastic condition of the breast that can lead to macromastia. The standard treatment for PASH is focal excision or rarely reduction mammoplasty. We present a rare case of postpartum bilateral rapid breast enlargement and axillary growth that was refractory to reduction mammoplasty. Ultimately, the patient required bilateral mastectomy and two‐stage implant‐based breast reconstruction. This more extensive form along with its management represents one of the few reported cases in the literature. The decision to pursue bilateral mastectomy was undertaken after exhausting more conservative options. Excellent aesthetic outcome and pain relief was obtained following definitive extirpative and reconstructive surgery. [ABSTRACT FROM AUTHOR]

Pseudoangiomatous stromal hyperplasia (PASH) represents a benign proliferation of myofibroblasts, classified as a benign tumor of mesenchymal tissue. Its clinical spectrum makes its diagnosis difficult. In pre-menopausal patients or under hormonal therapy it can mimic a fibroadenoma and in postmenopausal women suggest a phyllodes tumor, due to these characteristics the lesion represents a diagnostic radiological and pathological challenge. The present study describes a clinical case of PASH of nodular type, its radiological and pathological findings, as well as review of the literature. [ABSTRACT FROM AUTHOR]

Pseudoangiomatous stromal hyperplasia (PASH) is a benign breast condition commonly presented as an incidental microscopic finding. However, it can also manifest as a mass-forming lesion (tumorous PASH) or as gigantomastia (diffuse PASH). Most of the previously reported cases are unilateral tumorous PASH treated by mastectomy. In this article, we reported a rare case of diffuse bilateral PASH. A 21-year-old woman presented with a two-year history of bilateral breast enlargement and neck pain. Physical examination revealed asymmetrical bilateral macromastia with profound ptosis. Breast ultrasound demonstrated no cysts or masses in both breasts. The decision was made to perform an inverted T bilateral reductive mammoplasty which was performed successfully through a superior-central pedicle approach. Microscopic examination of the specimens confirmed the diagnosis of PASH without any evidence for malignancy. Nine months postoperatively, the size for both breasts was optimal the patient was satisfied. Recognition and reporting of this rare form of PASH is essential for proper investigation, pathology understanding, risk factors recognition, prognosis assessment and treatment methods selection. [ABSTRACT FROM AUTHOR]

Pseudoangiomatous stromal hyperplasia (PASH) is a benign lesion of breast composed of prolifereted stromal myofibroblastic cells. It is named due to presence of slit-like spaces without endothelial layer mimicing vascular structures. Most of the lesions detected incidentally in breast tissues resected with other causes. Occasionally it may presented as palpable or radiologically detectable mass. It may confused with malignancy or phylloides tumor in clinically or radiologically if it grows rapidly. Differential diagnosis includes angiosarcomas and other sarcomas on histopathological examination. In this report a PASH lesion presented with differential diagnostic criteria, detected in a 34 year of woman with a breast mass growing markedly in 6 months duration.

Anogenital mammary-like glands may give rise to various pathologic lesions identical to those known in mammary pathology. Tumor occurring in the anogenital region is extremely rare. The histogenetic origin of this tumor is controversial as it is being debated whether such lesions evolve from ectopic breast tissue and most recently, anogenital mammary-like gland. We report a 28-year-old girl who presented with a painless mass in the anogenital region, which was subsequently excised. Microscopic examination revealed morphologic pattern characteristic of benign phyllodes tumor with pseudoangiomatous stromal hyperplasia. We present this case to emphasize the importance of recognizing this uncommon lesion occurring at an extremely unusual site. We also discuss the histogenesis of phyllodes tumor and related lesions occurring in the anogenital region in light of the current literature along with a brief review of the previously reported cases of anogenital mammary-like glands.

Pseudoangiomatous stromal hyperplasia (PASH) is an uncommon benign proliferation of fibrous stroma, containing slitlike pseudovascular spaces lined by myofibroblasts. Less than 200 cases of PASH have been described in the English literature with the largest series including 40 cases. A 48-year-old woman with no particular past medical history, presented with a complaint of a slow, progressive, painless left breast mass. The patient underwent mammography which revealed a well delineated left breast nodule with microcalcifications classified BI-RADS 4. An excisional biopsy was performed on the mass to confirm the histological diagnosis. The specimen was a well-circumscribed whitish tumor measuring 3 x 3 cm with several microcysts (A). Histological examination revealed proliferation of fibrous stroma, with spindle cells and a network of slit-like empty clefts within acellular hyalinized stroma (B). The spindle cells were positive for CD34 and smooth muscle actin but were negative for Factor VIII. The final pathological diagnosis was nodular PASH. Postoperative course was uneventful and the patient is still being followed-up.

Pseudoangiomatous stromal hyperplasia (PASH) of the breast is a benign lesion manifesting as myofibroblastic proliferation and anastomosing slit‐like spaces. Atypical PASH is an extremely rare lesion characterized by cytological alteration of myofibroblast, presenting as myofibroblastic sarcoma arising from PASH. To our knowledge, only one other case has been reported since the first report of Rosen. We present a case of atypical PASH. A 39‐year‐old female presented with a round, elastic hard, painless mass in the left breast. Mammography and ultrasonography revealed no definitive sign of malignancy. Core needle biopsy report was suggestive of atypical PASH. Five months later, the mass had grown rapidly with pain. Considering the clinicopathological features, excision was performed. Pathological examination revealed the spindle cells proliferation in collagenous stroma. The spindle cell involved the adipose tissue and lobules and lined peudoangiomatous spaces. These cells exhibited marked cytological atypia and mitotic activity. Immunohistochemically, these spindle cells were positive for SMA, CD10, and bcl‐2, and negative for podoplanin, p63, CD31, ERG and cytokeratins. The final diagnosis was atypical PASH. She is tumor‐free on 12 months follow‐up. The nature of atypical PASH remains unknown. Further studies are required for a clear definition, a new histological entity and diagnostic criteria. [ABSTRACT FROM AUTHOR]

This article discusses a rare benign breast lesion called pseudoangiomatous stromal hyperplasia (PASH). PASH is typically found incidentally in breast biopsy material in premenopausal women and is usually asymptomatic. However, in rare cases, it can present as a palpable mass. The article reports a case of PASH in a 30-year-old female patient who had a small focal atypical ductal hyperplasia at the border of the lesion. The article also describes the radiologic appearance of PASH and highlights the importance of distinguishing it from other breast lesions. [Extracted from the article]

Pseudoangiomatous stromal hyperplasia (PASH) of the breast is a benign lesion, characterized by a dense proliferation of stromal mesenchymal cells of myofibroblastic origin forming empty, slit-like channels. We report PASH in a 12-year-old girl with a huge rapidly enlarged right breast. Biopsy of the mass showed histopathologic features characteristic of PASH. Immunohistochemical studies revealed diffuse positive membranous immunoreactivity to CD34. Although it is a benign lesion, lumpectomy was performed to minimize the damage from developing breast tissue.

Pseudoangiomatous stromal hyperplasia (PASH) of the breast is a benign mesenchymal lesion with incidental histologic findings. Surgical excision is recommended as the treatment of choice for PASH, although the recurrence rates after excision range from 15% to 22%. A 46-year-old-female presented with a six-month history of bilateral breast enlargement and painful sensation mimicking inflammatory carcinoma. Imaging studies demonstrated innumerable enhancing nodules in both breasts. Due to the growth of the lesions and progressive clinical symptoms, bilateral subcutaneous mastectomy was performed. Grossly, the specimens were round and well-circumscribed, and the histologic examination revealed PASH. After mastectomy, we created a pocket with the pectoralis major muscle and a lower skin flap, which was deepithelized. Anatomical mammary implants were inserted, and the nipple areolar complex was transferred to a new position as a free graft. The aesthetic result was satisfactory after twelve months of follow-up.

Pseudoangiomatous stromal hyperplasia (PASH) is a rare benign mesenchymal proliferative lesion of the breast. In this study, we aimed to show a case of PASH with mammographic and sonographic features, which fulfill the criteria for benign lesions and to define its recently discovered elastography findings. A 49-year-old premenopausal female presented with breast pain in our outpatient surgery clinic. In ultrasound images, a hypoechoic solid mass located at the 3 o’clock position in the periareolar region of the right breast was observed. Due to it was not detected on earlier mammographies, the patient underwent a tru-cut biopsy, although the mass fulfilled the criteria for benign lesions on mammography, ultrasound, and elastography. Elastography is a new technique differentiating between benign and malignant lesions. It is also useful to determine whether a biopsy is necessary or followup is sufficient.