ADOLESAN KIZ ÇOCUĞUNDA PSÖDOANJİYOMATÖZ STROMAL HİPERPLAZİ: OLGU SUNUMU VE LİTERATÜR DERLEMESİ

Psödoanjiyomatöz stromal hiperplazi (PASH) meme bağ dokusunun benign proliferatif lezyonlarından birisidir. Endotel benzeri iğsi hücrelerle döşeli yarık benzeri psödovasküler alanlarla karakterizedir. Meme eksizyonu ve jinekomasti piyeslerinde sıklıkla insidental olarak görülse de nadiren klinik bir sorun olarak karşımıza çıkmaktadır. Bu olgu sunumunda PASH nedeniyle aşırı derecede bilateral meme büyümesi ile kliniğimize başvuran adolesan bir kız çocuğunun klinik seyri ve tedavisi bildirilmektedir. Bu hastaya, serbest meme grefti kullanılarak meme küçültme ameliyatı yapıldıktan sonra gelişen nüks nedeniyle subkutan mastektomi yapılmış ve meme implantı yerleştirilmiştir. Anahtar Kelimeler: Psödoanjiyomatöz stromal hiperplazi; mamoplasti; meme İmplantları.

PSEUDOANGIOMATOUS STROMAL HYPERPLASIA (PASH) OF THE BREAST IN AN ADOLESCENT: A CASE REPORT AND LITERATURE REVIEW

Pseudoangiomatous stromal hyperplasia (PASH) is a benign proliferative lesion of the breast stroma characterized by slit-like pseudovascular spaces lined by endothelial-like spindle cells. It is frequently found as incidental microscopic foci in the female breast and in gynecomastia of the male breast, but it rarely presents as a clinical problem. We report a case of bilateral extreme breast enlargement caused by PASH in an adolescent girl who was treated with subcutaneous mastectomy and reconstruction with breast implants following a recurrence after treatment with free nipple graft breast reduction. Keywords: Pseudoangiomatous stromal hyperplasia; mammaplasty; breast implants. 

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  • 1. Vuitch MF, Rosen PP, Erlandson RA. Pseudoangiomatous hyperplasia of mammary stroma. Hum Pathol 1986;17(2):185-91.
  • 2. Leon ME, Leon MA, Ahuja J, Garcia FU. Nodular myofibroblastic stromal hyperplasia of the mammary gland as an accurate name for pseudoangiomatous stromal hyperplasia of the mammary gland. Breast J 2002;8(5):290-3.
  • 3. Badve S, Sloane JP. Pseudoangiomatous hyperplasia of male breast. Histopathology 1995;26(5):463-6.
  • 4. Haj M, Loberant N, Cohen I. Pseudoangiomatous hyperplasia of mammary stroma in a male breast presenting as a discrete nodule. Breast J 2005;11(6):472-3.
  • 5. Wieman SM, Landercasper J, Johnson JM, Ellis RL, Wester SM, Lambert PJ, Ross LA. Tumoral pseudoangiomatous stromal hyperplasia of the breast. Am Surg 2008;74(12): 1211-4.
  • 6. Drinka EK, Bargaje A, Ersahin CH, Patel P, Salhadar A, Sinacore J, Rajan P. Pseudoangiomatous Stromal Hyperplasia (PASH) of the Breast: A Clinicopathological Study of 79 Cases. Int J Surg Pathol 2011;20(1):54-8.
  • 7. Ozturk S, Yavuz E, Dursun M, Asoglu O, Ilhan R, Tuzlali S, Iplikci A. Pseudoangiomatous stromal hyperplasia of the breast (morphological and immunohistochemical analysis of 14 cases). Turk J Pathol 2005;21(3-4): 54-7.
  • 8. Guven E, Aydin H, Basaran K, Aydin U, Kuvat SV. Reduction mammaplasty using bipedicled dermoglandular flaps and free-nipple transplantation. Aesthetic Plast Surg 2010;34(6):738-44
  • 9. Dancey A, Khan M, Dawson J, Peart F. Gigantomastia--a classification and review of the literature. J Plast Reconstr Aesthet Surg 2008;61(5):493-502
  • 10. Schumacher O, Ashkar W, Dabernig J, Nenadic I, Ingianni G. Juvenile gigantomastia of extreme magnitude: a case report. Ann Plast Surg 2009;63(4):369-72.
  • 11. Baker SB, Burkey BA, Thornton P, LaRossa D. Juvenile gigantomastia: presentation of four cases and review of the literature. Ann Plast Surg 2001;46(5):517-25.
  • 12. Ibrahim RE, Sciotto CG, Weidner N. Pseudoangiomatous hyperplasia of mammary stroma. Some observations regarding its clinicopathologic spectrum. Cancer 1989;63(6):1154-60.
  • 13. Bowman E, Oprea G, Okoli J, Gundry K, Rizzo M, Gabram-Mendola S, Manne U, Smith G, Pambuccian S, Bumpers HL. Pseudoangiomatous stromal hyperplasia (PASH) of the breast: a series of 24 patients. Breast J 2012;18(3):242-7.
  • 14. Guray M, Sahin AA. Benign breast diseases: classification, diagnosis, and management. Oncologist 2006;11(5):435-49.
  • 15. Castro CY, Whitman GJ, Sahin AA. Pseudoangiomatous stromal hyperplasia of the breast. Am J Clin Oncol 2002;25(2):213-6.
  • 16. Pruthi S, Reynolds C, Johnson RE, Gisvold JJ. Tamoxifen in the management of pseudoangiomatous stromal hyperplasia. Breast J 2001;7(6):434-9.
  • 17. Powell CM, Cranor ML, Rosen PP. Pseudoangiomatous stromal hyperplasia (PASH). A mammary stromal tumor with myofibroblastic differentiation. Am J Surg Pathol 1995;19(3):270-7.
  • 18. Degnim AC, Frost MH, Radisky DC, Anderson SS, Vierkant RA, Boughey JC, Pankratz VS, Ghosh K, Hartmann LC, Visscher DW. Pseudoangiomatous stromal hyperplasia and breast cancer risk. Ann Surg Oncol 2010;17(12):3269-77.
  • 19. Ferreira M, Albarracin CT, Resetkova E. Pseudoangiomatous stromal hyperplasia tumor: a clinical, radiologic and pathologic study of 26 cases. Mod Pathol 2008;21(2):201-7.