Nipple Adenoma: Case Report of a Rare Entity.

Yagnya D Dalal,Yatri Patel,Darshit D Dalal,Aditya K Trivedi,Viraj Panchal

doi:10.7759/cureus.22996

Abstract

A nipple adenoma is a rare benign breast tumor. The commonest presentation of this rare entity is nipple erosion, serosanguinous discharge, induration, or tumor formation at the nipple. It often mimics malignant breast lesions or nipple eczema and is mistaken for Paget’s disease of the nipple or dermatological pathology. It may be misdiagnosed pathologically as ductal carcinoma of the breast. This may cause a diagnostic delay or a faulty diagnosis. Treatment is the excision of the tumor with or without nipple excision. Here, we report a case of nipple adenoma that projected out of the nipple along with nipple erosion, serosanguinous discharge, and occasional bleeding from the adenoma. A 37- year-old woman presented with a tumor on her right nipple for eight months, with the erosion of the nipple and serosanguinous discharge. The patient gave a history of a small amount of bleeding occasionally. Axilla was normal. The patient was advised to have a mammosonography. It showed an oval-shaped, well-demarcated, hypoechoic, uniformly solid nodule in the right nipple. There was no microcalcification seen on mammography. A punch biopsy was done to establish the diagnosis. It showed ductal hyperplasia and papillary proliferation of glandular structures suggestive of nipple adenoma. Complete resection of the tumor with partial excision of the nipple was done with a satisfactory cosmetic result. Though very uncommon, the possibility of nipple adenoma should be thought of when a patient presents with nipple erosion and discharge with or without a clinically obvious tumor. Timely diagnosis with histopathological correlation is important since it allows for less invasive surgical methods. In our case, we could attain a cosmetically satisfactory outcome without a remnant tumor. Paget’s disease of the nipple also has a similar clinical presentation, and it is a premalignant condition. The objective of presenting this case is to highlight the possibility of this rare benign condition, which may be easily missed clinically and also demands careful histopathological examination for its correct diagnosis.

Highlights

Nipple adenomas are benign and rare epithelial proliferations that arise from the lactiferous ducts of the nipple
We report a case of nipple adenoma that projected out of the nipple along with nipple erosion, serosanguinous discharge, and occasional bleeding from the adenoma
The possibility of nipple adenoma should be thought of when a patient presents with nipple erosion and discharge with or without a clinically obvious tumor

Summary

Introduction

Nipple adenomas are benign and rare epithelial proliferations that arise from the lactiferous ducts of the nipple. A 37-year-old woman presented with a red-colored tumor projecting through her right nipple for five months. It began as an erosion of the nipple with serosanguinous discharge for the initial two months, followed by the development of a soft, fragile tumor projecting out through the nipple (Figure 1). The tumor was seen projecting out of the right nipple with the erosion of the overlying part of the nipple The tumor was palpable through the whole length of the nipple up to its base Both the axillae and left breast were normal clinically. Both the axillae and left breast were unremarkable on mammosonography. The patient regularly comes for follow-up, and she is absolutely fine

Discussion

Conclusions

Disclosures