Homogeneous blue lumps of the nipple‐areola complex in pubertal girls

Abstract

Patient 1: A 10-year-old girl presented with a two-week history of a single blue nodule, located at the inferior aspects of her right areola (Figure 1). The lesion was superficial, soft, and smooth on palpation. On polarized dermoscopy, it showed a structureless light-blue dull color covering the entire lesion (Figure 2A). Highfrequency ultrasonography (US) revealed a lobulated, fluid-filled homogeneous anechoic mass located in the retroareolar tissue.The lesion presented a few internal septations and focal echogenic sediment and lacked any surrounding inflammatory changes. No internal vascularity was detected at power Doppler ultrasonography (PDUS) (Figure 3). The patient had an insignificant past medical history and was at PH1 (pubic hair, PH) B2 (breast, B) Tanner stage of development. Based on these findings, a diagnosis of a retroareolar cyst was made, and conservative management decided upon.The nodule remained stable at 3-month and 6-month follow-up visits, with no visible changes in color, size, or texture, either on dermoscopy or US.

Pubertal retroareolar cysts presenting as bluish lumps: New cases and literature review

“…Retroareolar cysts (RCs) are overlooked lesions that affect the nipple‐area complex (NAC) of pubescent girls 1 …”

“…Several reports have postulated that a hormone‐driven relaxation of the areolar muscle leads to duct expansion, resulting in poor reabsorption of gland secretions and squamous metaplasia of the epithelial lining. It is widely accepted that RCs originate from the obstruction and subsequent expansion of the terminal ducts draining Montgomery's tubercle, which is a sebaceous gland closely attached to the terminal segment of the lactiferous duct 1,2 …”