Abstract
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.
Highlights
Since the first description by Hartung of mammary tissue that had developed in the vulva of a 30-year-old female in 1872 many neoplastic and reactive conditions that are morphologically very similar to the lesions commonly seen in normal breast tissue have been described in the vulva or anogenital region [1]
The presence of ectopic breast tissue neighboring the lesion or in direct histological continuity with the lesion in some of the presented cases has supported this notion for a long time
Van der Putte has stated in 1991 and 1994 that this tissue represents the normal structure of the anogenital region and that similar lesions in the perianal region cannot be explained with the milk line theory [1,8]
Summary
Since the first description by Hartung of mammary tissue that had developed in the vulva of a 30-year-old female in 1872 many neoplastic and reactive conditions that are morphologically very similar to the lesions commonly seen in normal breast tissue have been described in the vulva or anogenital region [1] Such lesions include lactation glands, lactation adenoma, hydrocystoma, hydroadenoma papilliferum, non-mammary Paget disease and invasive adenocarcinoma [2]. Foci consisting of hyalinized collagen bands and slit-like spacing anastomosing with each other and lined with unspecified cells with no atypia or mitotic activity and no erythrocytes were present in the stroma (Figure 4) This specific hyalinized appearance of the stroma was interpreted as pseudoangiomatous stromal hyperplasia (PASH). Widespread apocrine metaplasia and (Turk Patoloji Derg 2017, 33:157-160)
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