Bilateral Simultaneous Pseudoangiomatous Stromal Hyperplasia of the Breasts and Axillae: Imaging Findings with Pathological and Clinical Correlation

Pseudoangiomatous stromal hyperplasia of the breast, imaging and clinical perspective: A review

Pseudoangiomatous stromal hyperplasia (PASH) is a benign breast pathology, which most commonly presents incidentally along with other breast pathologies. The etiology and pathogenesis of PASH are still unknown; however, there is some evidence suggesting PASH is hormone dependent. The clinical history, presentation, and imaging appearance of PASH are variable. Clinically, PASH has a wide spectrum of presentations, from being silent to gigantomastia. On imaging, PASH demonstrates various benign to suspicious features. Here we summarize PASH's clinical presentation, histopathology, imaging features, and management.

Bilateral diffuse tumorous pseudoangiomatous stromal hyperplasia treated with bilateral mastectomy in a 40-year-old woman

Pseudoangiomatous stromal hyperplasia (PASH) is a rare benign breast disease characterized by breast stromal proliferation mimicking low grade angiosarcoma. PASH is frequently detected as an incidental component coexisting with other breast lesions. However, it can also present as a single localized mass and is typically unilateral. Mammographic and sonographic findings are nonspecific and indistinguishable from those of benign lesions. We report an unusual case of PASH presenting with diffuse enlargement of the bilateral breasts in a 40-year-old woman treated with bilateral mastectomy.

An Uncommon Case of Bilateral Breast Enlargement Diagnosed as Tumoral Pseudoangiomatous Stromal Hyperplasia: Imaging and Pathological Findings

The incidence of reported pseudoangiomatous stromal hyperplasia (PASH), as well as the variability and severity of clinical presentations, is increasing in the literature. In parallel, several authors posit the need for an improved classification of PASH to avoid possible variables associated with this diagnosis. Here, we present a 25-year-old woman with PASH accompanied by severe bilateral and symmetrical breasts enlargement, highlighting an uncommon clinical presentation of PASH as much as the careful interdisciplinary review and correlation of histology and all available imaging studies to confirm the definitive diagnosis.