556 Case Report: Diagnosis of Bilateral PASH (Pseudoangiomatous Stromal Hyperplasia) in an 11-Year-Old Female

Abstract

Abstract PASH (Pseudoangiomatous stromal hyperplasia) is a rare pathological finding, defined as a benign mesenchymal proliferative lesion of the breast, presenting more frequently in premenopausal women. Although benign, differentiation from low grade Angiosarcoma due to their histological similarities. Management guidelines for PASH remain primitive due to the rarity in diagnosis and reporting of such cases. We present a very interesting case of an 11-year-old female assessed for her rapidly enlarging breasts. Initial management entailed right breast reduction Mammoplasty due to the presumed diagnosis of Macromastia. Histopathological assessment of the specimen initially reported the presence of Fibroadenoma. However, re-assessment by a senior Pathologist subsequently diagnosed the lesion as Pseudoangiomatous Stromal Hyperplasia (PASH). Further MRI imaging of both breasts revealed multiple, large, bilateral lesions. All identified bilateral breast lesions were excised, with a cumulative weight of 1.6 Kg, combined with WISE pattern reduction of the right breast overlying skin was carried out in due course. There has been no previous reporting of PASH in an 11-year-old female, which itself is a rare condition. Further studies on PASH are recommended to reduce the risk unnecessary surgical management of such cases due to misdiagnosis.