Tumoral pseudoangiomatous stromal hyperplasia (PASH) of the male breast: a systematic analysis.

Abstract

ABSTRACTAim: The study was conducted to systematically analyze the recent peer-reviewed literature related to tumoral pseudoangiomatous stromal hyperplasia (PASH) in males. Materials and methods: Articles published in peer-reviewed journals of repute from 2012–2023 were evaluated for eight variables, including: [i] age of the patient; [ii] clinical presentation; [iii] laterality (unilateral or bilateral); [iv] associated breast disorder; [v] systemic co-morbidity if any; [vi] imaging modalities that helped in diagnosis; [vii] treatment; and [viii] recurrence.Results: There were 10 cases ranging in age from 1 year to 67 years (mean 34.5 years). 8 cases (80%) had breast lumps, and 2 cases (20%) had axillary lumps at presentation. Pain was not a prominent symptom. Six cases (60%) had another breast disorder at presentation, and three cases (30%) had significant systemic co-morbidities, including diabetes and renal insufficiency. The greatest dimension of the lumps ranged from 2 cm to 12 cm, with 80% of the lumps being below 5 cm in size. Imaging modalities utilized in evaluation included breast ultrasound (USG), mammograms, computerized tomography (CT), and magnetic resonance imaging (MRI). All the cases were treated surgically, and the final diagnosis was made only after the analysis of the surgical specimen. Recurrence was recorded in two (20%) cases.Conclusion: Tumoral PASH is a benign myofibroblastic proliferation disorder rarely reported in males. This condition should be considered a differential diagnosis of breast or axillary lumps, and evaluation accordingly should be initiated. The recommended course of treatment is adequate surgical excision with regular clinical and radiological follow-up.