Dalal Yagnya D, Trivedi Aditya K, Panchal Viraj, Patel Yatri, Dalal Darshit D
Surgery, Gujarat Cancer Society (GCS) Medical College, Ahmedabad, IND.
Surgery, Ahmedabad Municipal Corporation's Medical Education Trust (AMCMET) Medical College, Ahmedabad, IND.
Cureus. 2022 Mar 9;14(3):e22996. doi: 10.7759/cureus.22996. eCollection 2022 Mar.
A nipple adenoma is a rare benign breast tumor. The commonest presentation of this rare entity is nipple erosion, serosanguinous discharge, induration, or tumor formation at the nipple. It often mimics malignant breast lesions or nipple eczema and is mistaken for Paget's disease of the nipple or dermatological pathology. It may be misdiagnosed pathologically as ductal carcinoma of the breast. This may cause a diagnostic delay or a faulty diagnosis. Treatment is the excision of the tumor with or without nipple excision. Here, we report a case of nipple adenoma that projected out of the nipple along with nipple erosion, serosanguinous discharge, and occasional bleeding from the adenoma. A 37- year-old woman presented with a tumor on her right nipple for eight months, with the erosion of the nipple and serosanguinous discharge. The patient gave a history of a small amount of bleeding occasionally. Axilla was normal. The patient was advised to have a mammosonography. It showed an oval-shaped, well-demarcated, hypoechoic, uniformly solid nodule in the right nipple. There was no microcalcification seen on mammography. A punch biopsy was done to establish the diagnosis. It showed ductal hyperplasia and papillary proliferation of glandular structures suggestive of nipple adenoma. Complete resection of the tumor with partial excision of the nipple was done with a satisfactory cosmetic result. Though very uncommon, the possibility of nipple adenoma should be thought of when a patient presents with nipple erosion and discharge with or without a clinically obvious tumor. Timely diagnosis with histopathological correlation is important since it allows for less invasive surgical methods. In our case, we could attain a cosmetically satisfactory outcome without a remnant tumor. Paget's disease of the nipple also has a similar clinical presentation, and it is a premalignant condition. The objective of presenting this case is to highlight the possibility of this rare benign condition, which may be easily missed clinically and also demands careful histopathological examination for its correct diagnosis.
乳头腺瘤是一种罕见的乳腺良性肿瘤。这种罕见疾病最常见的表现是乳头糜烂、浆液性血性溢液、硬结或乳头处肿瘤形成。它常酷似恶性乳腺病变或乳头湿疹，被误诊为乳头派杰病或皮肤病病理。其病理检查可能被误诊为乳腺导管癌。这可能导致诊断延迟或错误诊断。治疗方法是切除肿瘤，可连带或不连带切除乳头。在此，我们报告一例乳头腺瘤病例，该腺瘤从乳头突出，伴有乳头糜烂、浆液性血性溢液，腺瘤偶尔出血。一名37岁女性右乳头出现肿物8个月，伴有乳头糜烂和浆液性血性溢液。患者有偶尔少量出血史。腋窝正常。建议患者进行乳腺超声检查。检查显示右乳头有一个椭圆形、边界清晰、低回声、均匀实性结节。乳腺X线摄影未见微钙化。进行了切取活检以明确诊断。结果显示导管增生和腺管乳头状增生，提示为乳头腺瘤。对肿瘤进行了完整切除并部分切除乳头，美容效果满意。尽管非常罕见，但当患者出现乳头糜烂和溢液，无论有无临床明显肿物时，都应考虑乳头腺瘤的可能性。及时结合组织病理学进行诊断很重要，因为这样可以采用侵入性较小的手术方法。在我们的病例中，我们获得了美容效果满意且无肿瘤残留的结果。乳头派杰病也有类似的临床表现，且是一种癌前病变。展示此病例的目的是强调这种罕见良性疾病的可能性，它在临床上可能容易被漏诊，且正确诊断需要仔细的组织病理学检查。
