A Case of Breast Pseudoangiomatous Stromal Hyperplasia with Local Recurrence

Abstract

We report a case of breast pseudoangiomatous stromal hyperplasia (PASH) with local recurrence. The patient was a 42-year-old woman. In 2022, she noticed a 50 mm mass in the A area of her right breast and sought medical attention at our hospital. A core needle biopsy (CNB) confirmed the diagnosis of PASH, after which she underwent a tumorectomy. The histopathological examination confirmed PASH, with positive surgical margins. After discussion with the patient, we opted for a follow-up approach. Six months post-surgery, ultrasonography revealed hypoechoic masses measuring 52 mm and 23 mm at the previous surgical site. CNB demonstrated the growth of vascular-like spaces lined with spindle cells in the fibrous stroma, with the spindle cells testing positive for CD34. Consequently, she received a diagnosis of PASH and underwent tumorectomy. Immunohistochemically, the stromal spindle cells were positive for CD34, α-SMA, and Bcl-2 and negative for ER, PgR, Desmin, D2-40, CD31, and Factor VIII. Approximately six months after the second surgery, there were no signs of recurrence. We present this case along with a literature review.