Pseudoangiomatous stromal hyperplasia is an uncommon benign condition of mesenchymal proliferation. Fewer than 1500 cases have been reported in previous literature. It is observed most commonly in postmenopausal and perimenopausal women and is extremely rare to present in children. Recommended treatment in severe cases is often mastectomy due to high incidence of recurrence. However, a careful review of the literature suggests that treatment of this benign disease should be tailored to the mode in which it presents. This case report describes a 16-year-old girl with a severe case of bilateral pseudoangiomatous stromal hyperplasia that was managed with reduction mammoplasty, along with a 10-year case follow-up. Based on a literature review of more than 2800 cases and the current case report, a conservative management strategy is suggested, depending on disease presentation.
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