Nipple adenoma

Nipple adenoma is a rare, benign breast lesion which often mimics a malignancy

Clinical presentation 

Patient presents with bloody discharge from an ulcerated and painful nipple in one breast. There is itching associated with this lesion. Symptoms may show variation with the menstrual cycle. There may be enlargement of the nipple and sometimes a mass may be palpated.

Epidemiology

Can occur in any age group but most often seen in the age group of 40-50 years. It is seen in both females and males (<5%).

Pathology

Gross pathology

A well circumscribed and unencapsulated lesion.

Microscopic

Glands with stromal fibrosis and epithelial hyperplasia.

Radiographic features

Mammogram

Usually small in size lesions, which are not picked up on ultrasound. If seen they are seen as an indistinct mass in the region of the nipple.

Ultrasound

Mostly seen as a small (0.5 -1.5 cm),  well-circumscribed nodule in the superficial part of the nipple with homogeneous echogenicity. On doppler these lesions are hypervascular. Doppler sonography may also aid in diagnosis since most of these entities are hypervascular.

Treatment and prognosis

It is believed to be a premalignant lesion. Complete excision with a narrow rim of uninvolved breast tissue is adequate treatment.

Differential diagnosis

• Paget's disease of the breast
• ductal adenoma
• infiltrating syringomatous adenoma of the nipple
• intraductal papilloma of the breast
• tubular adenoma

Siehe auch:

• Mamillen-Areolen-Komplex
• pathologische Kontrastmittelaufnahme des Mamillen-Areolen-Komplex
• Tumoren der Mamille