Acta Médica Costarricense (Sep 2008)
Lesión nodular de mama de crecimiento rápido A Nodular and Fast Growing Breast Mass
Abstract
La hiperplasia estromal seudoangiomatosa es un hallazgo histológico benigno, relativamente infrecuente, caracterizada por aumento de la densidad mamaria, proliferación de fibras colágeno y del estroma que forma pseudoespacios capilares vacíos anastomosados entre sí. La etiología no es clara, pero tiene una marcada influencia hormonal. Tanto clínica como radiológicamente puede semejar lesiones benignas y malignas. La histología es fundamental para hacer el diagnóstico definitivo. Se reporta el caso clínico de una mujer herediana de 40 años con una masa mamaria derecha, deformante, asimétrica, de crecimiento rápido, dolorosa y multirecidivante, que finalmente resolvió con una mastectomía subcutánea.Pseudoangiomatous stromal hyperplasia of the breast is a rare benign disease, which was described by Vuitch in 1986. The etiology is not clear, but an hormonal influence has been demonstrated. To confirm the diagnosis, a biopsy is required primarily to distinguish a malignant disease like low grade angyosarcoma, a fibroadenoma or a Philloides tumor; these entities are similar in their clinical and imaging features. We present herein the case of a 40 year old female that presented with a fast growing, painful, recurrent breast mass, initially treated as fibrocystic breast disease but the histopathology later demonstrated the lesion to be a pseudoangiomatous stromal hyperplasia, which is very infrequent. Finally she underwent a sucutaneuos mastectomy, and the diagnosis was again confirmed. An extensive review of current literature confirmed that mastectomy is better, especially in cases with diffuse and recurrent tumors.
