Affiliations: [a] Department of General and Specialized Surgery, Faculty of Medicine, Hashemite University, Zarqa, Jordan | [b] Department of Basic Medical Sciences, Faculty of Medicine, Hashemite University, Zarqa, Jordan | [c] Department of the Health of Woman, Child and Urological Diseases, Sant’Orsola – Malpighi Hospital, University of Bologna, Bologna, Italy | [d] Intern, King Abdullah University Hospital, Irbid, Jordan
Correspondence:
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Corresponding author: Mahmoud Al-Balas, Assistant Professor of Surgery, Department of General and Specialized Surgery, Faculty of Medicine, Hashemite University, P.O. Box: 330127, Zarqa-13133, Jordan. Tel.: 00962 796076650; E-mail: Mahmoud_albalas@hu.edu.jo
Abstract: Pseudoangiomatous stromal hyperplasia (PASH) is a benign breast condition commonly presented as an incidental microscopic finding. However, it can also manifest as a mass-forming lesion (tumorous PASH) or as gigantomastia (diffuse PASH). Most of the previously reported cases are unilateral tumorous PASH treated by mastectomy. In this article, we reported a rare case of diffuse bilateral PASH. A 21-year-old woman presented with a two-year history of bilateral breast enlargement and neck pain. Physical examination revealed asymmetrical bilateral macromastia with profound ptosis. Breast ultrasound demonstrated no cysts or masses in both breasts. The decision was made to perform an inverted T bilateral reductive mammoplasty which was performed successfully through a superior-central pedicle approach. Microscopic examination of the specimens confirmed the diagnosis of PASH without any evidence for malignancy. Nine months postoperatively, the size for both breasts was optimal the patient was satisfied. Recognition and reporting of this rare form of PASH is essential for proper investigation, pathology understanding, risk factors recognition, prognosis assessment and treatment methods selection.
