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Nipple adenoma – a case report

Vesna Ramljak ; Department of Cytology, University Hospital for Tumors, Zagreb, Croatia
Irena Ranogajec ; Department of Cytology, University Hospital for Tumors, Zagreb, Croatia
Božena Šarčević ; Department of Pathology, University Hospital for Tumors, Zagreb, Croatia
Danko Velimir Vrdoljak ; Department for Surgical Oncology, University Hospital for Tumors, Zagreb, Croatia

Abstract

The paper presents a case of a rare benign lesion of the breast - nipple adenoma. Nipple adenoma is a benign tumor without connective tissue cores composed of small tubules lined by epithelial and myoepithelial cells with or without proliferation of the epithelial component around collecting ducts. In 1955, Jones considered it as a separate clinical pathologic entity. The tumor most often develops in women between 40-50 years of age in the form of erythema, crust or ulceration, and it is therefore often mistaken for Paget's disease. We report a case of a patient referred to our cytology laboratory for clinical suspicion of malignancy, with an erythematous, exulcerated nipple and occasional hemorrhagic discharge. The mammographic finding was normal and sonography indicated a smaller hypoechogenous zone immediately below the nipple. Scraping material for cytologic analysis was stained by the standard MGG staining raising the suspicion of a malignant tumor.
The nipple containing a tumor of a firm consistency underwent PHD analysis. Biposies of standard H&E-stained sections showed the tumor partly covered with multilayered squamous epithelium, with ducts revealing scattered epithelial proliferation and the diagnosis of nipple adenoma was made. Due to its rare occurrence, clinical presentation and cytologic pattern of increased cellularity, dissociation of epithelial cells with occasional signs of atypia, the tumor is often misinterpreted and cytologically classified as carcinoma. For nipple lesions presented as exulcerated changes, and any changes in the nipple's appearance in general, except for Paget's disease, the possibility of a benign tumor ,such as adenoma of the nipple, should always be taken into consideration.
The treatment of choice consists of the removal of the entire nipple since foci of carcinoma can sometimes, although rarely, be found in a nipple adenoma, too.

Keywords

nipple adenoma; cytology diagnostics

Hrčak ID:

281799

URI

https://hrcak.srce.hr/281799

Publication date:

3.12.2003.

Article data in other languages: croatian

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