Intraductal papilloma of the breast: A case report

Abstract

KEYWORDSBloody nipple discharge; Intraductal papilloma; Sonography.Abstract Intraductal papillomatous lesions in the breast may be manifestations of different histological types of tumors, including papillomas and intraductal papillary carcinomas. Intraductal papillomas are relatively rare, with an incidence of 2e3%. They are benign tumors that arise from the mammary duct epithelium. We observed a tumor of this type in a 51-year-old woman who had noted bloody discharge from her right nipple. She was referred for breast sonography a few days later. The sonographic examination revealed a dilated duct enclosing a mass, which was surgically removed. Histological examination revealed that the lesion was benign (intraductal papilloma). This case illustrates the role of imaging in confirming clinical diagnoses of papillomatous lesions. Histological confirmation is always necessary, however, to rule out the presence of intraductal papillary carcinoma.Sommario Le alterazioni papillomatose intraduttali della mammella includono un vasto range di lesioni con caratteristiche diverse, tra cui il papilloma e il carcinoma papillare intraduttale. Il papilloma intraduttale è una lesione relativamente rara con un'incidenza relativa del 2 e3%. Si tratta di un tumore benigno che origina dall'epitelio dei dotti mammari. Riportiamo il caso di una donna di 51 anni presentatasi all'ambulatorio ecografico del nostro Istituto, dopo aver notato una secrezione ematica dal capezzolo di destra, pochi giorni prima. L'esame ecografico evidenziava un dotto dilatato con all'interno una vegetazione. Si procedeva a escissione chirurgica; l'esame istologico poneva la diagnosi di lesione benigna (papilloma intraduttale). Il caso in esame sottolinea il ruolo dell'imaging, che è quello di confermare la diagnosi clinica di lesione papillomatosa, mentre la diagnosi finale è sempre istologica in particolare la diagnosi differenziale con il carcinoma intraduttale papillare. ª

Are Irregular Hypoechoic Breast Masses on Ultrasound Always Malignancies?: A Pictorial Essay

“…Intraductal papillomas are usually benign breast tumors that are epithelial proliferations of the lactiferous ducts ( 39 ). There are two types of intraductal papillomas, central and peripheral.…”

“…There are two types of intraductal papillomas, central and peripheral. The central types arise within the subareolar region and are solitary palpable masses in perimenopausal women, whereas the peripheral types are multiple peripheral masses within the terminal ductal lobular unit that develop in young women ( 39 40 ). The most common cause of unilateral, single-pore, spontaneous ductal discharge is papilloma ( 41 42 ).…”

“…The usual appearance of an intraductal papilloma on mammography is a well-defined, round solitary subareolar mass with a radiolucent halo. Occasionally, in one-fourth of all cases, the lesion is associated with a coarse calcification or microcalcification ( 39 ). Ductography can help to define the sites, numbers, and extent of presumed papillomas.…”

A Case of Benign Intraductal Papilloma Presenting with a Giant Palpable Mass Located in the Breast

“…They are solitary tumors and arise most frequently during the perimenopausal period. Peripheral intraductal papillomas tend to be multiple, and are observed among young women, arising within the terminal duct-lobular unit [1]. The average diameter of benign papillary neoplasm is 1.8 cm whereas atypical or malignant papillary neoplasm is 2.2 cm in diameter [2].…”

Diagnostic dilemmas in Intraductal papillomas of the breast - Experience at Sultan Qaboos University Hospital in the Sultanate of Oman

“…Histological analysis reveals proliferation of the ductal epithelium surrounded by myoepithelial cells and a fibro vascular stroma. 1 Although these lesions are benign, there is controversy about their diagnosis, mainly because of diversity in their clinical presentation and histopathology. 2 Clinically, they present most commonly as nipple discharge, known as pathological nipple discharge, which can be either blood stained, serous or coloured.…”