A 35-year-old woman presenting with an unusual post-traumatic leiomyoma of the nipple: a case report

Abstract

IntroductionLeiomyoma of the mammary papilla is one of the most uncommon nipple tumors with only 50 cases reported in the literature until now. To the best of our knowledge we present the first report of a nipple leiomyoma that originated from a traumatic abrasion caused by breastfeeding.Case presentationA 35-year-old healthy Caucasian female with a cauliflower-like tender and pink nodular mass that was approximately 10mm in diameter presented to our out-patients department. The patient suggested that the mass originated from a traumatic abrasion caused by breastfeeding three years ago and it has been slowly growing ever since.An excision biopsy was performed. The histological and immunohistochemical examination confirmed the diagnosis of leiomyoma. There were no postoperative complications or any sign of local recurrence four years postoperatively.ConclusionsLeiomyoma of the mammary papilla is a rare benign neoplasm that usually appears as a solid tender nodule. Differential diagnosis comprises breast carcinoma, leiomyosarcoma and myoid hamartoma. The recommended treatment is complete excision of the tumor with histologically confirmed tumor-free margins otherwise recurrence is possible. A detailed history of the patient’s disease can reveal the original etiology. This is an original case report that will have particular interest to plastic surgeons, dermatologists, and pathologists. The pathogenetic mechanism was trauma of the nipple. According to our review of the literature this particular information has never been reported and we think that it may advance our knowledge of this very infrequent tumor.

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.…”

“…The references of the papers were reviewed and all relevant articles were also examined (total 43). Different entities that were described included: neurofibroma, leiomyoma, milium, florid papillomatosis, syringomatous adenoma, nevoid hyperkeratosis, fibroma, pseudolymphoma and hemangioma . Table summarizes the papers for each entity.…”

“…b) and immunohistochemistry (SMA) test confirmed the diagnosis of leiomyoma. Leiomyoma of the nipple is a benign, tender and extremely rare tumour with only 50 cases reported in the literature until now . The main reason that leads patients with nipple leiomyomas to their physicians is chronic pain …”

“…Bulman 8 Doctor et al 9 Nascimento et al 10 Tsujioka et al 11 Pujol et al 12 Velasco et al 13 Kaufman et al 14 Christenson et al 15 Chaudhary et al 16 Ku et al 17 Pavlidis et al 18 Milia Mishra et al 19 Berk et al 20 Florid Papillomatosis Nichols et al 21 Smith et al 22 Doctor et al 9 Perzin et al 23 Miyahara et al 24 Montemarano et al 25 Sugai et al 26 Kijima et al 27 Syringomatous adenoma of the nipple Rosen 28 Coulthard et al 29 Toyoshima et al 30 Wadhwa et al 31 Ichinokawa et al 32 Nevoid hyperkeratosis Levy-Frankel 33 Mold et al 34 Vestey et al 35 Perez-Izquierdo et al 36 D'Souza et al 37 Okan et al 38 Xifra et al 39 Kubota et al 40 Krishnan et al 41 Fibroma of the nipple Iancu et al 42 Parlakgumus et al 43 Pseudolymphoma of the nipple Bafverstedt 44 Ackerman 45 Schmid et al 46 Smyczek-Gargya et al 47 Haemangioma of the nipple Doctor et al 9 reported in the literature until now. [8][9]…”

Leiomyoma of the Nipple: A Rare Entity at Rare Site

“…More commonly seen in middle-aged females with a sex ratio of 3:1, the causation has been linked with estrogen and progesterone [2]. Oral contraceptive pills (OCPs) and past history of trauma are other predisposing factors [3]. Nipple leiomyoma has also been reported to occur in males [4], sporadically or associated with gynecomastia.…”