Resection of giant pseudoangiomatous stromal hyperplasia: Expectant observation and avoidance of complex breast surgery

INTRODUCTION: Pseudoangiomatous stromal hyperplasia (PASH) is a benign tumor of the breast that can achieve large, or even giant, dimensions. Resection of giant tumors can pose cosmetic challenges. CASE PRESENTATION: We report the prospective cosmetic outcome of a 31-year old female with a 21-cm PASH tumor of the right breast using simple excision through an inframammary approach. The patient was followed for 6 months before final cosmesis was established. Breast cosmesis was considered very good by both patient and physician. Mild external rotation of the nipple and mild contour changes involving the lateral aspect of the breast persisted at 6 months. DISCUSSION: Avoidance of more complex alternatives such as reduction mammoplasty and/or mastopexy was achieved by allowing the skin envelope to undergo natural involution over a period of six months. CONCLUSION: Inframammary simple excision of a giant PASH tumor is appropriate in select patients.