Pseudoangiomatous Stromal Hyperplasia (PASH) in Adolescence: A Systematic Review

Dottoressa Francesca Pellini, Maya Lorenzi, Rossella Gaudino, Beatrice Accordini, Sara Mirandola, Alessandra Invento and Giovanni Paolo Pollini

Department of Breast Unit Surgery, Azienda Ospedaliera Integrata di Verona, Italy
Department of Surgery, Dentistry, Paediatrics and Gynaecology, University of Verona, Italy

^*Correspondance to: Dottoressa Francesca Pellini 

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Abstract:

Objective: Pseudoangiomatous Stromal Hyperplasia (PASH) of the breast is a benign mesenchymal proliferative lesion occurring most commonly in middle-aged, premenopausal women and it’s exceptionally rare in adolescents. The aim of this study is to present a review of the literature on PASH in childhood, comparing its results with our new cases, and to define a standard approach for its treatment. Design and Patients: We describe PASH in 3 pediatric patients and compare them with 24 adolescent cases described in literature. Main Outcome Measures: Primary outcome was the type of treatment in adolescent patients with diagnosis of breast PASH. Secondary outcomes were the evidence of recurrence and the cosmetic results, associated with the patient satisfaction.
Results: All 24 patients described in literature underwent surgical excision of the lesion, the large majority a breast-conserving procedure. None of them had a recurrence, except for an adolescent female. Our 3 patients underwent surgically excision through breast-conserving circumareolar incisions. A slight breast asymmetry was still remaining, but it is improving spontaneously with the patient’s growing.
Conclusion: PASH benign nature and complete healing after surgical resection represent aspects of tranquility which must be communicated to the patient, often worried because of the big size and the fast growth of the lesion. Preoperative core biopsy and hormonal therapy could be two new instruments to avoid surgery in some patients, but more likely in adults.

Keywords:

PASH; Adolescence; CD31; CD34

Cite the Article:

Pellini DF, Lorenzi M, Gaudino R, Accordini B, Mirandola S, Invento A,et al. Pseudoangiomatous Stromal Hyperplasia (PASH) in Adolescence: A Systematic Review. World J Surg Surgical Res. 2018; 1: 1058.