Nipple Papilloma with Dysplasia: A Case Report

Nipple papilloma is an uncommon benign breast tumour. Polypoid lesions arising from the surface of the nipple include nipple papilloma, fibroepithelial stromal polyp of the nipple. These must be differentiated from malignant lesions involving the nipple, like Paget’s disease of the nipple, and malignant breast lesion with nipple involvement. Detailed clinical examination, and to a great extent, imaging helps to differentiate these lesions. Hereby, authors report a case of 46-year-old female presented with abnormal growth arising from the right nipple. On full field digital mammography, bilateral breasts revealed scattered fibroglandular breast parenchyma {American College of Radiology (ACR) type B). An irregular hyperdense mass with lobulated margins is seen superior to right nipple which measured approximately 16×14 mm. The case was managed by local curative excision under local anaesthesia. On gross histopathology, the lesion showed squamous epithelium consisting of variable levels of acanthosis and hyperkeratosis, and focal parakeratosis which also shows focal ulceration and moderate to severe dysplasia and mixed inflammation consistent with papilloma. Histopathological examination has a role in differentiating the benign lesions like nipple papilloma from fibroepithelial stromal polyp of nipple and also helps in determining the presence of atypical hyperplasia, dysplasia or carcinoma in-situ.