Adenoma of the nipple

Abstract

We report herein a case of a 42 year old woman with adenoma of the nipple of her left breast. The diseased nipple was enlarged, reddened and a hard elastic mass was palpable within its substance. There was an area of eczematoid erosion on the surface. Incisional biopsy revealed a picture of adenoma and therefore the nipple was excised. Five years postoperatively, there has been no recurrence of the disease. To our knowledge, only thirteen cases of adenoma of the nipple have been reported in the Japanese literature. Some clinical features and treatments are discussed in a review following the case report. Although rare, adenoma of the nipple should be borne in mind to avoid a misdiagnosis of malignancy and unnecessarily extensive surgery.

Rare benign tumours of the nipple

“…The references of the papers were reviewed and all relevant articles were also examined (total 43). Different entities that were described included: neurofibroma, 5-7 leiomyoma, [8][9][10][11][12][13][14][15][16][17][18] milium, 19,20 florid papillomatosis, 9,[21][22][23][24][25][26][27] syringomatous adenoma, [28][29][30][31][32] nevoid hyperkeratosis, [33][34][35][36][37][38][39][40][41] fibroma, 42,43 pseudolymphoma and [44][45][46][47] hemangioma. 9 Table 1 summarizes the papers for each entity.…”

Adenoma of the nipple projecting out of the nipple: curative resection without excision of the nipple

“…It was first described by Jones [3] and occurs most often in 40- to 50-year-old patients [2,6]. The common clinical symptoms are nipple discharge and erosion or ulceration, in addition to a palpable tumor below the nipple [5,6]. Our case showed a unique palpable tumor under the nipple that was continued with a red granulation-like tumor on top of the nipple.…”

“…Although there are previous reports of total excision of the nipple and the areola with an underlying wedge of the breast and a complete resection of the nipple in patients with larger lesions, these procedures seem to be overly aggressive for benign disease [2,5,8]. In the present case, we were able to perform curative resection through a periareolar incision without excision of the nipple.…”

“…The most common symptom is erosion of the nipple and nipple discharge, followed by induration or tumor formation at the nipple [5,6]. Adenoma of the nipple is an uncommon lesion that is often mistaken clinically for Paget’s disease and misinterpreted pathologically as ductal carcinoma [1-3,6-9].…”

Nipple adenoma in infancy

“…Although this condition is most commonly referred to as nipple adenoma [5,6], other terms have been used: florid papillomatosis [2,3], subareolar duct papillomatosis [7], erosive adenomatosis [7,8], and papillary adenoma [1]. Nipple adenoma typically presents in middle-aged women as a crusted mass with induration and serous or bloody discharge; men are rarely affected [7,[9][10][11][12][13]. Treatment options include excision [14], cryosurgery [15], or Mohs micrographic surgery [16].…”