An unusual case of a large fibroepithelial stromal polyp presenting as a nipple mass

Abeer M Shaaban,EPL Turton,William Merchant

doi:10.1186/1756-0500-6-345

Abeer M Shaaban, EPL Turton + Show 1 more

Open Access

https://doi.org/10.1186/1756-0500-6-345

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Abstract

BackgroundFibroepithelial stromal polyps (FESP) are benign lesions that typically occur in the genital area and are known to represent a diagnostic challenge for pathologists. Not only do they have a spectrum of morphological changes that ranges from bland morphology to rather atypical appearances, but they also share morphological features with a number of benign and malignant lesions.This is a report of a rare presentation of a FESP of the breast.Case presentationWe describe an unusual case of a large polypoid mass arising from the nipple and connected to it by a long pedicle in a female of 45. The lesion comprised spindle and stellate shaped cells with bizarre stromal giant cells. The morphological and immunohistochemical diagnostic features are provided together with a discussion of possible mimics.ConclusionFESPs may occur in the female breast. It is important to differentiate the lesion from other benign and malignant spindle cell lesions particularly metaplastic carcinoma.

Highlights

Fibroepithelial stromal polyps (FESP) are benign lesions that typically occur in the genital area and are known to represent a diagnostic challenge for pathologists
Fibroepithelial stromal polyps (FESP) are benign lesions recognised in the skin, oral cavity, urinary tract [1] and genital area [2]
In this report we present a case of 45 year old female presenting with a large polypoid nipple mass

Summary

Background

Fibroepithelial stromal polyps (FESP) are benign lesions recognised in the skin, oral cavity, urinary tract [1] and genital area [2] They are recognised as posing diagnostic problems in the vulvo-vaginal region for the practising pathologist. We present a case of a fibroepithelial stromal polyp arising in the nipple and showing histological appearances of those described in the vulvovaginal region. Case presentation This is a 45 year-old lady with no relevant medical history. The specimen was examined by both breast and soft tissue pathologists by H&E and immunohistochemistry The latter included EMA, desmin, calponin, caldesmon, EMA, S100, CD34, factor XIIIA, oestrogen receptor and progesterone receptor. The patient remained well and follow-up showed no regrowth or recurrence

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