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Case of the Month


strange growth around breast woman

A 50-year-old woman presented with these changes on her left breast/areola. She said she first noticed a few papules 5-6 years ago. They have progressively spread since then. The area is not painful or pruritic. Unfortunately, she reports that the folds and crevices accumulate material and develop a smell foul if not carefully and regularly cleaned. She has no known family history of such lesions. She is otherwise healthy and only takes losartan for hypertension, which she started 2 years ago.

What's Your Diagnosis?


Diagnosis: Nipple Papillomatosis (Florid papillomatosis of the nipple)

strange growth microscopic view
strange growth microscopic image

Pathology Report

Microscopic Description:
The lesion has a papillomatous configuration.  There is hyperkeratosis over an undulating epidermis. The stroma is vascular and fibrous, and a moderate amount of inflammation is present.  Mammary ducts are absent.  Smooth muscle present. No evidence of malignancy.
Final Diagnosis:
Skin, areola, left
PAPILLOMA, FIBROVASCULAR

Discussion

Nipple Papillomatosis is a benign condition. It is characterized by the development of multiple benign papillomas, usually in the 4th and 5th decade of life. 
The condition has also been called nipple adenoma and florid papillomatosis of the nipple.  Nipple Papillomatosis is a completely benign clinical condition and carries an excellent prognosis.
In her case, I referred her to a breast surgeon specialist for a consultation regarding additional evaluation and aesthetic and hygienic recommendations.

 

For additional information on Nipple Papillomatosis, please see the references below.

References:

https://dermnetnz.org/topics/nipple-papillomatosis
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1395317/
https://pubmed.ncbi.nlm.nih.gov/25585841/


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Charles Crutchfield III M.D. Eagan Dermatologist

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