Pseudoangiomatous stromal hyperplasia (PASH) w gruczole piersiowym : opis przypadków

Bibliogr. s. 92

Background: Pseudoangiomatous stromal hyperplasia (PASH) of the breast is a rare benign proliferation of breast stroma usually diagnosed accidentally during pathological examination of other lesions, but in some cases presenting as a rapidly growing tumor. On clinical examination and imaging it may be mistaken for phyllodes tumor or fibroadenoma and on pathological examination for a lowgrade angiosarcoma. The treatment of choice for PASH is surgical removal with wide margins, because of the recurrence possibility. However, the lesion is neither associated with malignancy nor considered as a premalignant one. Case Report: A 28-year-old female presented with a large, painless, right breast tumor. In US an extensive, well circumscribed hypoechoic mass with small cysts inside was found. In MR a large, well circumscribed lesion with heterogeneous signal was found, in dynamic examination with enhancement curve type Ib, suggesting benign dysplasia. The second patient, a 22-year-old female presented with a fast growing, small, painless right breast tumor. In US a well circumscribed hypoechoic area behind the nipple was found. In MR no well circumscribed area behind the nipple was found, but scattered lesions, in dynamic examination with enhancement curve type Ib, suggesting benign dysplasia. In both patients on pathological examination of material obtained in US guided mammotomic biopsy PASH was diagnosed. Both patients refused lesion excision, so have been followed-up with US every 6 months and MR every year, with no progression found in the course of 4 years in the first and 6 years in the second patient. Conclusions: Tumoral form of PASH is a rare pathology, but it should be known by radiologists, because of features overlapping with other pathological lesions, particularly low-grade angiosarcoma.