Axillary lymph node metastases from papilloma of the breast

Abstract

10764 Background: To report a unique case of papilloma of the breast with metastases to the axillary lymph node. Methods: Case report and review of literature. Results: 80 year old Caucasian male presented with right gynacomastia of 3 months duration. The lesion was resected. Pathology was consistent with intraductal papilloma with hyperplasia and no evidence of malignancy. Subsequently, after 2–3 weeks a mass was noted in the right axilla. This mass was resected and was found to be consistent with papilloma of the axillary lymph node and had the pathological characteristics of the original breast papilloma. Conclusion: Solitary papillomas are generally lesions of the large ducts usually located in the subareolar region of the breast. They are among the commonest cause of spontaneous nipple discharge. After resection of the primary lesion, local recurrence is fairly common. Recurrence is especially common if hyperplasia is associated with the papilloma. There is also an increased incidence of carcinoma in the affected breast. Due to the benign nature of papillomas, they do not metastasize. We did an extensive review of literature and did not find any cases of metastatic lesions from a papilloma of the breast. The underlying reason and pathogenesis for the metastases is not known. No significant financial relationships to disclose.

Unusual recurrent metastasizing benign breast papilloma: a case report

“…Although the absence of an intact ME cell layer in the fibrovascular core suggests carcinoma, its presence does not always exclude malignancy [10][11][12][13] growth and high-grade nuclei support carcinoma [14]. Also, very few cases have been reported of metastases from benign papillomas, and all of them were reported as metastases to the axillary lymph node [5][6][7][8]. To our knowledge, we report the first case of a benign breast papilloma extending into the chest wall and also involving the internal mammary node.…”

“…Papillomas with atypia are associated with up to a four times increased risk of malignant transformation, and unlike benign papillomas, malignant papillary lesions may be associated with lymph node and distant metastases [2,4]. Benign breast papillomas presenting with local or distant metastases have been reported very rarely [5][6][7][8]. We present an unusual case of an African American woman with a recurrent, benign breast papilloma with malignant behavior.…”

Papillary Neoplasm of Breast-Changing Trends in Diagnosis and Management

“…The peripheral papillomas arise in the terminal duct lobular units and are often discovered incidentally on imaging studies and risk of carcinoma is even higher than solitary papilloma. And very rarely, benign papillomas of breast presenting with local or distant metastases have been reported [10][11][12][13][14][15][16][17][18]. However, behavior and management of papillary carcinoma whether in situ or invasive remain a matter of debate.…”