DUAL PATHOLOGY IN THE BREAST: A RARE CASE REPORT OF PSEUDOANGIOMATOUS STROMAL HYPERPLASIA OVERLAPPING WITH INVASIVE DUCTAL CARCINOMA IN A POSTMENOPAUSAL FEMALE

Abstract

Pseudo-angiomatous Stromal Hyperplasia (PASH) is a benign myofibroblastic proliferation of
the breast stroma. It is typically hormone-responsive and found more frequently in younger females. The
coexistence of PASH with invasive ductal carcinoma in postmenopausal women is uncommon. This is a
case of a 51-year-old postmenopausal female, presenting with a painful lump in the left breast. Both the
clinical and radiological findings were suggestive of malignancy and the patient was planned for a
modified radical mastectomy. The histopathological analysis revealed a dual pathology of invasive
ductal carcinoma overlapping with PASH-like areas in the adjacent stroma. This case highlights the
importance of accurate histopathological evaluation to differentiate PASH from malignant vascular
tumors and to manage the underlying malignancy. Timely and accurate diagnosis of PASH might be
helpful in prevention of unnecessary diagnostic and therapeutic interventions. Management of IDC
preoperative, surgical and adjuvant therapy can address PASH alongside.