Introduction/Background Pseudoangiomatous stromal hyperplasia (PASH) is a rare but benign mesenchymal proliferative lesion of the breast simulating a vascular lesion. A rare condition overall, PASH is most common in premenopausal women. It’s usually an incidental finding but may produce palpable or mammographic mass.

Methodology We retrospectively reviewed data from 2010 to 2018 of patients diagnosed with PASH by surgical excision or image-guided biopsy.

Results In five cases; the patients ranged in age from 33 to 49 years. 2 of our patients had a history of fibroadenoma, and 3 of the patients were nulliparous. The revelation was clinical, with the self-discovery of a breast lump in all cases. 4 patients (58%) were diagnosed on surgical excision of a breast mass, one was diagnosed with core needle biopsy. The tumors ranged in size from 1 cm to 6 cm with the smallest tumor occurring in a 45-year-old woman. Breast masses were more prevalent on the left side than on the right (85% and 15%). All of the patients were treated with surgical excision.

Conclusion PASH may present as a giant tumor in the breast which may achieve a large size with time. Earlier diagnosis and simple surgical excision should be preferred to conserve the breast.

Disclosures Tumorous PASH is treated by local surgical excision with clear margins and the prognosis is excellent, with minimal risk of recurrence after adequate surgical excision.