Nipple Adenoma: A Differential Diagnosis for Paget's Disease

Abstract

A 59-year-old woman presented with a 1-month history of an ulcerated left nipple. This was associated with an intermittent bloody discharge. The surrounding areola was thickened and indurated. There was no nipple inversion ( Fig. 1).On examination the nipple was slightly erythematous. A 0.5 cm ulcer was located over the lower third of the nipple. A hemoserous discharge was present. There were no palpable breast masses and no associated adenopathy.The lesion was clinically suspicious of Paget's disease of the nipple. The patient had a mammogram that revealed no abnormality and then had a biopsy of the ulcerated area.The biopsy revealed a proliferation of glandular structures suggestive of a benign adenomatous process. The patient then had local curative excision of the lesion. Histology confirmed a proliferation of glandular tissues, all of which were invested by a myoepithelial cell layer (Fig. 2). Figure 2. Double layer of myoepithelial cells investing a proliferation of glandular tissue. Florid intraductal epithelial hyperplasia is also present. (Hematoxylin and eosin; magnification ×40.)Figure 1. Preoperative picture of the ulcerated nipple.

Adenoma of the nipple: A clinicopathological report of 13 cases

“…It has been defined as erosive adenomatosis of the nipple, papillary AN, florid adenomatosis, florid papillomatosis of the nipple, subareolar duct papillomatosis and superficial papillary adenomatosis of the nipple (2,8,12). Since the main feature common to these lesions is adenomatous proliferation in the stroma (small and medium caliber duct proliferation) (1,4), the definition of AN was preferred in the current study.…”

“…The lesion, also known as erosive adenoma and florid papillomatosis, appears similar to a hard-elastic nodule that deforms the nipple, causing swelling or erosion with serous or hematic secretion. AN is often confused with Paget’s disease (4) and the differential diagnosis with breast carcinoma is often difficult (5,6). …”

RETRACTED: Nipple adenoma in a man: An unusual case report

“…Nipple adenoma is often clinically misdiagnosed as Paget's disease of the breast. 3,4 In the World Health Organization classification of breast tumour, established in 2003, AN is defined as "a compact proliferation of small tubules lined by epithelial and myoepithelial cells, with or without proliferation of the epithelial component, around the collecting ducts of the nipple." 5 Histologically, it is sometimes difficult to distinguish nipple adenoma from carcinoma arising in the nipple.…”

Adenoma of the Nipple, Mimicking Paget’s Disease of the Breast: Report of a Case

“…Women in their 4th and 5th decades commonly affected and usually they presents with unilateral, serous or bloody nipple discharge in the presence of crusting. The main differential diagnosis is Paget's disease of the nipple based on similar clinical features like soreness, ulceration and swelling of the nipple, sometimes with discharge [3] [4]. However, Paget's disease is more common in older women and Paget's cells can be detected by aspiration biopsy cytology.…”