Bilateral pseudoangiomatous stromal hyperplasia in childhood gigantomastia: A challenge in reconstruction and management

The presence of mammary nodules during childhood and adolescence is somewhat unusual, generally consisting of benign lesions. Despite the range of possible diagnoses, they are generally similar in clinical terms. In the rare cases where these lesions constitute a case of gigantomastia, the differential diagnosis must be between juvenile fibroadenomatosis, phyllodes tumours and other even less common diseases of the mammary gland, such as Pseudoangiomatous Stromal Hyperplasia (PASH). This is caused by the exacerbated proliferation of mature fibroblasts and myofibroblasts, with the trigger factor still unknown. This study reports on a rare case of bilateral PASH in a young patient, describing its diagnosis and the surgical technique used.