A Case Report: Pseudoangiomatous Stromal Hyperplasia Tumor Presenting as a Palpable Mass

Abstract

We report a case of woman with a palpable lump on her left breast. On mammography, a huge mass located between the inner and the outer inferior breast quadrants of the left breast was found. The ultrasound examination realized later revealed a heterogeneous mass with smooth and lobulated borders. An MRI was also performed, showing an oval mass with heterogeneous areas of enhancement. Finally, a core biopsy under sonographic guidance revealed a pseudoangiomatous stromal hyperplasia of the breast.

Keywords: MRI; breast tumor; mammography; phyllode tumor; pseudoangiomatous stromal hyperplasia.

Figure 1

Mammography performed with craniocaudal (A) and mediolateral oblique (B) incidences of the left breast shows a huge well-defined mass located between the inner and the outer inferior quadrants, with no suspicious features.

Figure 2

Ultrasound of the left breast centered on the palpable lump showing an oval, heterogeneous lesions with smooth borders.

Figure 3

MRI showing the mass on the left breast with lobulated appearances. On T2-weighted MR image with fat saturation (A), the lesion demonstrates a heterogeneous appearance with areas of low and high signal. On T1-weighted MR image (B), the lesion shows a more homogeneous appearance with a hyposignal. On T1-weighted MR image with gadolinium and fat saturation (C), the mass demonstrates a heterogeneous enhancement, with a polylobulated appearance. No lymphadenopathies are seen.

Figure 4

Microscopic examination showing a pseudo vascular proliferation delineated with endothelial cells with canalar hyperplasia without atypia, without invasion of parenchyma.