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Treatment of Pseudoangiomatous Stromal Hyperplasia of the Breast: Implant-Based Reconstruction with a Vascularized Dermal Sling

  • Jung, Bok Ki (Institute for Human Tissue Restoration, Department of Plastic and Reconstructive Surgery, Yonsei University College of Medicine) ;
  • Nahm, Ji Hae (Department of Pathology, Yonsei University College of Medicine) ;
  • Lew, Dae Hyun (Institute for Human Tissue Restoration, Department of Plastic and Reconstructive Surgery, Yonsei University College of Medicine) ;
  • Lee, Dong Won (Institute for Human Tissue Restoration, Department of Plastic and Reconstructive Surgery, Yonsei University College of Medicine)
  • Received : 2015.04.16
  • Accepted : 2015.06.23
  • Published : 2015.09.15

Abstract

Pseudoangiomatous stromal hyperplasia (PASH) of the breast is a benign mesenchymal lesion with incidental histologic findings. Surgical excision is recommended as the treatment of choice for PASH, although the recurrence rates after excision range from 15% to 22%. A 46-year-old-female presented with a six-month history of bilateral breast enlargement and painful sensation mimicking inflammatory carcinoma. Imaging studies demonstrated innumerable enhancing nodules in both breasts. Due to the growth of the lesions and progressive clinical symptoms, bilateral subcutaneous mastectomy was performed. Grossly, the specimens were round and well-circumscribed, and the histologic examination revealed PASH. After mastectomy, we created a pocket with the pectoralis major muscle and a lower skin flap, which was deepithelized. Anatomical mammary implants were inserted, and the nipple areolar complex was transferred to a new position as a free graft. The aesthetic result was satisfactory after twelve months of follow-up.

Keywords

References

  1. Vuitch MF, Rosen PP, Erlandson RA. Pseudoangiomatous hyperplasia of mammary stroma. Hum Pathol 1986;17:185-91. https://doi.org/10.1016/S0046-8177(86)80292-1
  2. Takagi H, Miyairi J, Hata M, et al. A case of tumor-forming pseudoangiomatous stromal hyperplasia of the breast. Breast Cancer 2013;20:187-90. https://doi.org/10.1007/s12282-009-0188-7
  3. Virk RK, Khan A. Pseudoangiomatous stromal hyperplasia: an overview. Arch Pathol Lab Med 2010;134:1070-4.
  4. Salemis NS. Giant tumoural pseudoangiomatous stromal hyperplasia of the breast in the adolescence. ANZ J Surg 2011; 81:469-70. https://doi.org/10.1111/j.1445-2197.2011.05774.x
  5. Singh KA, Lewis MM, Runge RL, et al. Pseudoangiomatous stromal hyperplasia: a case for bilateral mastectomy in a 12- year-old girl. Breast J 2007;13:603-6. https://doi.org/10.1111/j.1524-4741.2007.00499.x
  6. Masannat YA, Whitehead S, Hawley I, et al. Pseudoangiomatous stromal hyperplasia: a case report. Case Rep Med 2010;2010:549643.
  7. Powell CM, Cranor ML, Rosen PP. Pseudoangiomatous stromal hyperplasia (PASH): a mammary stromal tumor with myofibroblastic differentiation. Am J Surg Pathol 1995; 19:270-7. https://doi.org/10.1097/00000478-199503000-00004
  8. Lardi AM, Ho-Asjoe M, Mohanna PN, et al. Immediate breast reconstruction with acellular dermal matrix: factors affecting outcome. J Plast Reconstr Aesthet Surg 2014;67:1098-105. https://doi.org/10.1016/j.bjps.2014.05.020
  9. Krishnan NM, Chatterjee A, Van Vliet MM, et al. A comparison of acellular dermal matrix to autologous dermal flaps in single-stage, implant-based immediate breast reconstruction: a cost-effectiveness analysis. Plast Reconstr Surg 2013; 131:953-61. https://doi.org/10.1097/PRS.0b013e3182865a24

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  2. Case Report: a rare case of PASH mimicking a lactational adenoma vol.7, pp.None, 2015, https://doi.org/10.12688/f1000research.13909.1
  3. Breast reconstruction with a dermal sling: a systematic review of surgical modifications vol.53, pp.1, 2019, https://doi.org/10.1080/2000656x.2018.1533840
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