<p>Erosive Adenomatosis of the Nipple: A Clinical Diagnostic Challenge</p>

Abstract

Erosive adenomatosis of the nipple (EAN) is a rare benign neoplasm of the nipple. The entity is generally characterized by erosion, serous discharge (serous and/or sanguineous), nodularity, swelling, itching and erythema of the nipple. It may be confused with mammary Paget’s disease of the nipple and obtain over-treatment. We reported a patient with typical clinical and histopathological features. Clinicians should consider EAN as one of the differential diagnosis in patients with erosions on the nipple.

Adenoma of the nipple: a mimic of breast malignancy

“…It is often asymptomatic, but patients sometimes present with swelling and complain of itching, pain, and/or erythema. Serosanguinous discharge, although rare, results in the formation of a superficial crust [1][2][3]. In advanced stages or larger lesions the nipple may become nodular, firm, or even deformed [2].…”

“…In this setting, although ultrasonography has proved useful in determining the diagnosis, histological examination if still fundamental [4]. Other nipple diseases that should be included in the clinical differential diagnosis are atopic and contact dermatitis of the nipple, psoriasis, extragenital primary syphilis, lactiferous duct ectasia, herpes simplex virus infection, impetigo, nipple wart, and other rare benign tumors such as leiomyoma, neurofibroma, or fibroma of the nipple [1][2][3]5].…”

“…Adenoma of the nipple (AN), previously known as erosive adenomatosis of the nipple or florid papillomatosis of the nipple, is a rare benign breast tumor which originates in the lactiferous ducts of the nipple. It commonly appears in women in their fourth or fifth decade of life and is exceptional in men and children [1,2].…”

“…Mohs micrographic surgery [9] and nipple splitting enucleation technique [10] can remove the tumor completely and preserve this important area cosmetically, functionally, and psychologically. Alternative treatment interventions include cryotherapy, cryosurgery, or radiofrequency, especially in those cases in which preservation of intact nipple tissue is preferred [1][2][3]. Local recurrence is not infrequent, especially in incompletely excised lesions or when conservative treatment methods are used.…”

“…Although the coexistence of AN and ipsilateral or contralateral breast cancer has been reported in the literature, this association is difficult to establish. Currently, it remains unclear as to whether AN represents a risk factor for the development of breast carcinoma or acts as a premalignant lesion [1][2][3]. The majority of authors believe that the probability of developing breast cancer in patients with AN is similar to that of the general population.…”