Acuña GonzálezD Shaw DRJ, Maciel MJA, Caro SCHS, Pérez BMP

Language: Spanish
References: 7
Page: 13-19
PDF size: 424.10 Kb.

ABSTRACT

Introduction: PASH was described 1986 by first time Vuitch et al. Definition: Benign stromal proliferation that simulates a vascular injury. The prevalence is very difficult to estimate, is rare, less than 150 cases reported since its description in 1986, up 2007. Signs and symptoms: up to 70% is presented as an incidental finding and 30% has a lump or thickening firm without pain. Most lesions are asymptomatic firm, well circumscribed, mobile, in a range of 1-15 cm. Although it has been describe in immunocompromised pediatric men it is more common in premenopausal women and in postmenopausal women wth hormone replacement therapy. Imaging studies: ultrasound: an homogeneous, hypoechoic, well-defined edges solid lesion is identified. It can be mistaken for a fibroadenoma unlike this presents internal removing, or vascular channels. Paget and colleagues reported solid hypoechoic masses with cystic component areas. Cohen and colleagues reported 6/7 solid lesions, hypoechoic, an a case with a hypoechoic nodule espiculado. Mammography, are presented as well-defined solid lesions not associated with calcifications. Histology: PASH is established as an incidental diagnosis in 23% can be confused with angiosarcoma low grade, with sclerosing lobular hyperplasia, miofibroblastoma and a phyllodes tumor has increased the number of progesterone receptors in miofibroblasos. It characterized by express CD34, vimentin, and actin, desmin and BCL-2.If there is a suspicious lesion PASH in a biopsy trucut, it should be performed an excisional biopsy for confirmation. Etiology: Its origin is unknown. Rosen et al describe the formation of a nodule related with an exaggeration of a physiological event. During the luteal/secretory phase of the menstrual cycle. Has not been associated with an increased risk of cancer development. Treatment: Extension of the surgery depends on the size of the lesion and the symptoms of the patient. Cases with diffuse disease have an increased risk of recurrences, so they requires mastectomies. A recent publication showed that management through monitoring, can be considered in patients with comorbidities that are nor ableto have a surgical procedure. There are publications that have documented the benefit of tamoxifen. However information on methods of reconstruction in patients with PASH have not been published.

REFERENCES

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