Jason McCartt, Sarah Heaton, Juan Lopez, Randy Hamill, William Thomas, Heather Burch, Bradley Bandera. DDEAMC
Objective: Pseudoangiomatous stromal hyperplasia (PASH) is a rare benign breast condition characterized by the proliferation of mesenchymal cells. PASH typically effects pre and perimenopausal women. It is extremely rare in the adolescent population. It must be clearly distinguished from other benign and malignant breast conditions such as: juvenile breast hypertrophy, giant fibroadenoma and phyllodes tumor. The authors present a case of a rapidly enlarging mass in an adolescent female consistent with PASH along with a current literature review.
Methods: A 12 year old female presents 6 months following menarche with a rapidly enlarging mass of the right breast. Ultrasound suggested a large fibroadenoma. An MRI was obtained that demonstrated a 15 by 15 centimeter well-demarcated mass with compression of the native breast tissue. Subsequent core needle biopsy demonstrated PASH.
Results: The patient underwent successful wide local excision of the associated mass (1500 grams). Immediate reconstruction was performed with a free nipple graft. Pathology was consistent with PASH.
Conclusions: PASH is a rare diagnosis in the adolescent population. For treatment purposes it must be distinguished from other potential diagnoses: juvenile breast hypertrophy, giant fibroadenoma and phyllodes tumor. A core needle biopsy should be considered as it will likely guide further treatment.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 87264
Program Number: MSSP08
Presentation Session: Military iPoster (Non CME)
Presentation Type: MSSPoster
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