Case 8: Solitary Intraductal Papilloma

Ed, Pisano; Mp, Braeuning; Burke, Eithne

doi:10.1148/radiology.210.3.r99mr37795

Cited by 8 publications

(7 citation statements)

References 9 publications

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“…Galactography may reveal an intraluminal filling defect, duct diltation, contrast extravasation, or complete obstruction 3-6. Galactography may reveal and help localize the lesion for biopsy and may also reveal additional lesions 4,5. Although carcinomas are frequently encountered, there are no definitive galactographic criteria for differentiation of benign from malignant lesions.…”

Section: Introductionmentioning

confidence: 99%

Diagnostic Value of 3D Fast Low-Angle Shot Dynamic MRI of Breast Papillomas

Son

Kim

et al. 2009

Yonsei Med J

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PurposeTo evaluate the value of breast MRI in analysis of papillomas of the breast.Materials and MethodsFrom 1996 to 2004, 94 patients underwent surgery due to papillomas of the breast. Among them, 21 patients underwent 3D fast low angle shot (FLASH) dynamic breast MRI. Eight masses were palpable and 11 of 21 patients had nipple discharge. Two radiologists indifferently analyzed the location, size of the lesions and shape, margin of the masses, multiplicity and ductal relation. The MRI findings were categorized according to breast imaging reporting and data system (BI-RADS) lexicon. The amount and pattern of enhancement and associated findings were also evaluated according to BI-RADS. We then compared the MRI findings with galactography, mammography and breast ultrasonography (US) and examined histopathologic correlation.ResultsOn breast MRI, the lesion size was 0.4-1.59 cm, and 18 patients showed subareolar location. On 4.25 cm (mean 1.54) dynamic enhanced images, imaging findings showed mass (n = 10), intracystic mass (n = 3), focus (n = 5), ductal enhancement (n = 2), and segmental enhancement (n = 1). In cases of the masses, the shapes of the masses were round (n = 4), lobulated (n = 3), and irregular (n = 6), and margins were circumscribed (n = 6), microlobulated (n = 5), and indistinct (n = 2). The enhancement patterns were homogeneous enhancement (n = 7), heterogeneous (n = 3) or rim enhancement (n = 3).ConclusionThe contrast enhanced dynamic breast MRI was highly sensitive for diagnosis of breast papillomas. MRI could play a key role in the pre-operative work-up for multiple papillomas and papillomatosis.

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Section: Introductionmentioning

confidence: 99%

Diagnostic Value of 3D Fast Low-Angle Shot Dynamic MRI of Breast Papillomas

Son

Kim

et al. 2009

Yonsei Med J

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“…This opinion results from its ability to detect small tumors and to detect the presence of a tumor from such indirect signs as dilatation of the mammary duct. 8 We were able to detect the tumor in this patient by careful scanning using the immersion method. Ultrasound is a conventional technique; however, it is noninvasive and can access a lesion from many aspects.…”

Section: Discussionmentioning

confidence: 85%

“…7 Multiple papilloma is thus considered to be a precancerous condition. 8 On the other hand, cases of solitary papilloma with merged breast cancer are rare. 1 Breast cancer occurring in a solitary papilloma is assumed to be associated with atypical ductal hyperplasia, not with the papilloma itself.…”

Section: Discussionmentioning

confidence: 99%

“…Ultrasound imaging of intraductal papillomas has been reported to reveal a well-defi ned, smooth-walled, solid, hypoechoic mass, as in this case, or a lobulated, smooth-walled cystic lesion with some solid components. 8 Many workers claim that ultrasound is considerably more sensitive in the diagnosis of intraductal tumors than when used to diagnose other diseases. This opinion results from its ability to detect small tumors and to detect the presence of a tumor from such indirect signs as dilatation of the mammary duct.…”

Section: Discussionmentioning

confidence: 99%

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A case of solitary intraductal papilloma of the breast coexisting with ductal carcinoma in situ (DCIS)

Takemoto¹,

Yamamoto²,

Shiraishi³

et al. 2007

J Med Ultrasonics

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A 54-year-old woman was referred to this institution because of spontaneous bloody discharge from the nipple of her left breast in July 2003. Physical examination revealed no mass, but minimal pressure on the mammary gland exuded a bloody discharge from the nipple. No lymph node swelling was recognized in the axillary or subclavicular regions. Mammography and magnetic resonance imaging revealed mastopathy. Ultrasonography on the immersion method demonstrated a dilated duct with an irregular, solid, hypoechoic mass immediately behind the nipple. Fine-needle aspiration cytology showed the mass to be an intraductal tumor. Carcinoembryonic antigen (CEA) concentration of the nipple discharge was 400 ng/ml. Preoperatively, she was diagnosed as intraductal solitary papilloma, and endoscope-assisted microdochectomy was carried out under general anesthesia. The tumor was 10.5-10.6 mm in diameter and had developed from the posterior wall of the duct adjacent to the nipple. The tumor contained a small solid area in which a two-cell layer of epithelium was missing, and thus solitary papilloma coexisting with ductal carcinoma in situ (DCIS) was diagnosed. Solitary intraductal papilloma coexisting with carcinoma is rare; cases of DCIS are exceptionally rare. Follow-up for 3 years has revealed no evidence of recurrence.

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“…Mammography is typically the first imaging modality for symptomatic spontaneous single duct nipple discharge, which has many differential diagnoses including intraductal papilloma, fibrocystic changes, Paget’s disease of the breast, and intraductal carcinoma [ 8 ]. On mammography, the most usual findings of an IDP are either a negative mammogram, dilated ducts [ 9 ], and/or a round or oval circumscribed mass, with or without calcifications present [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

Mammographic and Sonographic Findings of Intraductal Papilloma of the Right Breast: A Case Report

Hodge¹,

Mirchandani²,

Shah³

2023

Cureus

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Intraductal papillomas are tumors that arise in the epithelial cells of the mammary duct. Common presenting symptoms for intraductal papilloma include serous or serosanguinous nipple discharge or a palpable mass. We present a case of a 48-year-old woman who presented with spontaneous right breast nipple discharge and a palpable mass. Diagnostic imaging for the patient included mammography and ultrasound with color doppler imaging that revealed a mass at eight o'clock in the right breast at a distance of 2 cm from the nipple and that corresponded to the area of palpable concern. Percutaneous ultrasoundguided biopsy of the mass confirmed a diagnosis of intraductal papilloma. Surgical excision may be required in many cases of an intraductal papilloma due to the variety of diagnoses that can be included on the differential, the increased risk for cellular atypia, and the treatment for spontaneous nipple discharge.

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Case 8: Solitary Intraductal Papilloma

Cited by 8 publications

References 9 publications

Diagnostic Value of 3D Fast Low-Angle Shot Dynamic MRI of Breast Papillomas

Diagnostic Value of 3D Fast Low-Angle Shot Dynamic MRI of Breast Papillomas

A case of solitary intraductal papilloma of the breast coexisting with ductal carcinoma in situ (DCIS)

Mammographic and Sonographic Findings of Intraductal Papilloma of the Right Breast: A Case Report

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