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Case Reports: Unusual presentation of more common disease/injury
Bloody nipple discharge due to intraductal papilloma in an adolescent girl
  1. Claire Alexandra Ostertag-Hill1,
  2. Yihong Wang2,
  3. Stana Nickolich3 and
  4. Doreen L Wiggins1
  1. 1Department of Surgery, Rhode Island Hospital, Brown University Warren Alpert Medical School, Providence, Rhode Island, USA
  2. 2Department of Pathology and Laboratory Medicine, Rhode Island Hospital, Brown University Warren Alpert Medical School, Providence, Rhode Island, USA
  3. 3Brown University Warren Alpert Medical School, Providence, Rhode Island, USA
  1. Correspondence to Dr Doreen L Wiggins; doreen.wiggins{at}brownphysicians.org

Abstract

An early adolescent girl was referred to our breast surgery clinic with multiple right-sided breast masses and several months of unilateral bloody nipple discharge. MRI demonstrated multiple enhancing masses in the right breast with intrinsic hypertensive T1 signal of the ducts extending to the nipple. A biopsy showed partially sclerosed intraductal papillomas without atypia or malignancy. Following extensive counselling with the patient and her family, two palpable breast masses and a single central breast duct responsible for bloody nipple discharge were fully excised. Histopathological analysis showed unique overlapping features of resembling intraductal papilloma, nipple adenoma and fibroadenomas. The patient has had resolution of her bloody nipple discharge and excellent cosmetic outcomes post-surgery. Intraductal papilloma is rare in the adolescent population and the risk of concurrent and future malignancy is not well established. Thus, a tailored approach to the work-up and management of paediatric breast masses is essential.

  • Breast surgery
  • Pathology

http://dx.doi.org/10.1136/bcr-2022-254177

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    Footnotes

    • Twitter @CostertagHillMD

    • Contributors CAO-H and SN collected data and drafted and revised the manuscript. YW carried out histopathological analyses and critically reviewed the manuscript. DLW supervised data collection and critically reviewed the manuscript for important intellectual content.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.