title: Bilateral Diffuse Pseudoangiomatous Stromal Hyperplasia (PASH) Causing Gigantomastia in a 33-Year-Old Pregnant Woman: Case Report.
abstract: Pseudoangiomatous stromal hyperplasia (PASH) is a benign proliferation of mammary stroma mostly described as an incidental microscopic finding. Clinically, it can manifest as a palpable, well-circumscribed breast mass or in rare cases as a diffuse bilateral process causing massive breast enlargement. The most postulated theory for aetiology of this condition is hormonal stimulation of mammary myofibroblasts, particularly by progesterone. A definite diagnosis of PASH is based on typical pathological findings like stromal hyperplasia and empty slit-like channels positive for myofibroblastic and negative for endothelial markers. The main clinical differential diagnosis is a fibroadedoma or phylloid tumour, and histologically a low-grade angiosarcoma. There are less than 200 cases of tumorous PASH and less than 20 of diffuse PASH reported so far. Here we present a case report of huge diffuse PASH, that is, to our knowledge, the first in a pregnant woman.
authors.affiliation: Department of Obstetrics and Gynaecology, Heinrich-Heine University, Düsseldorf, Germany, Düsseldorf, Germany.
authors.forename: Natalia
authors.initials: N
authors.lastname: Krawczyk
authors.affiliation: Department of Obstetrics and Gynaecology, Heinrich-Heine University, Düsseldorf, Germany, Düsseldorf, Germany.
authors.forename: Tanja
authors.initials: T
authors.lastname: Fehm
authors.affiliation: Department of Obstetrics and Gynaecology, Heinrich-Heine University, Düsseldorf, Germany, Düsseldorf, Germany.
authors.forename: Eugen
authors.initials: E
authors.lastname: Ruckhäberle
authors.affiliation: Department of Obstetrics and Gynaecology, Heinrich-Heine University, Düsseldorf, Germany, Düsseldorf, Germany.
authors.forename: Svjetlana
authors.initials: S
authors.lastname: Mohrmann
authors.affiliation: Department of Pathology, Heinrich-Heine University, Düsseldorf, Germany.
authors.forename: Jasmin
authors.initials: J
authors.lastname: Riemer
authors.affiliation: Department of Pathology, Heinrich-Heine University, Düsseldorf, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Braunstein
authors.affiliation: Department of Obstetrics and Gynaecology, Heinrich-Heine University, Düsseldorf, Germany, Düsseldorf, Germany.
authors.forename: Jürgen
authors.initials: J
authors.lastname: Hoffmann
keywords: Breast; Diffuse pseudoangiomatous stromal hyperplasia; Mastectomy; PASH; Pregnancy