Hiperplasia estromal pseudoangiomatosa de la mama (HEPA): estudio clínico, radiológico y patológico de 4 casos

Abstract

Pseudoangiomatous stromal hyperplasia (PASH) is a rare benign breast lesion, characterized by a benign overgrowth of fibrous connective tissue of the breast, which produces numerous spaces resembling vascular structures. This entity most commonly affects premenopausal women but cases have been described at all ages ranging from 12 to 75 years. PASH is usually an incidental histological finding after surgery for benign or malignant tumors but may also present as a mass or painless nodule mimicking fibroadenoma. Ultrasound-guided percutaneous biopsy allows the type of lesion to be determined and malignancies, such as low-grade angiosarcoma, to be excluded. We report four new cases of PASH with distinct clinical presentations. The first two cases presented as a single painless breast mass, the third as an incidental finding in the surgical specimen from a quadrantectomy performed for an intraductal breast carcinoma, and the fourth case occurred in a man with unilateral gynecomastia.