Syringomatous tumor of the nipple

Multimodality
approach to the nipple-areolar complex: a pictorial review and diagnostic algorithm. Syringomatous tumor of the nipple. A 47-year-old woman with retraction and hardening of the left nipple. a Mammogram shows retraction of the left nipple and asymmetric retroareolar density. b On ultrasound, the lesion is solid and hypoechogenic with ill-defined borders and increased peripheral color-Doppler signal. c Contrast-enhanced coronal T1-weighted MRI (subtracted image obtained 120 s after contrast injection) shows mass-type uptake with pronounced early enhancement in a lesion with hazy borders that retracts the nipple-areolar complex. d Hematoxylin-eosin stain (× 4) shows a proliferation of elongated glandular structures like strings of cells in the dermis, with the formation of keratin cysts (star)
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Infiltrating syringomatous adenoma of the nipple is a relatively rare, benign dermal neoplasm of the areola and nipple.

Clinical presentation

Syringomatous adenomas of the nipple usually present as unilateral 1 to 3 cm firm lesion in the subareolar or nipple region of the breast. Tenderness, itchiness, crusting, ulceration, and nipple discharge or nipple inversion may be present. Average age at the time of presentation is 40 years of age.

Pathology

Gross

Dermal nodule in the subareolar location.

Histologically

Epidermal acanthosis and pseudoepitheliomatous hyperplasia. Dermal infiltrates of curved, ductular structures lined by flattened-to-cuboidal cells, often with proteinaceous debris and skin-type keratin seen in their lumens. Keratinous cysts are often seen .

Treatment and prognosis

Complete excision is curative, with local recurrences occurring in 30% of incompletely excised lesions.

History and etymology

It was first described by Rosen in 1983.

Differential diagnosis

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Assoziationen und Differentialdiagnosen zu Syringomatous tumor of the nipple: