Intraductal papilloma presenting as a breast mass in an 8-month-Old male infant: A case report

IF 0.2 Q4 PEDIATRICS
Maen Kamal , Nesma Ghanim , Raima Hashmi , Zachary Patterson , Qazi Azher , Antonio J. Williams Sr
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Abstract

Introduction

Intraductal papilloma is an exceptionally rare condition in the pediatric population, particularly among males in infancy and early childhood, typically most prevalent among women aged between 35 and 55 years presenting as sanguineous or serosanguineous nipple discharge and a discrete breast mass. Despite its historical classification as benign, emerging research indicates a potential for malignant transformation, prompting a reevaluation of its clinical significance.

Case presentation

We present the case of a healthy 8-month-old male infant with a right subareolar breast swelling that appeared non tender, well-circumscribed, smooth, mobile, rubbery, without any associated nipple discharge or regional lymphadenopathy, clinically measuring 10 × 10 mm in diameter, and exhibited a bluish green hue with no associated changes in overlying skin. Ultrasound confirmed presence of a right retro areolar breast mass, characterized as a multiseptated complex cyst-like structure with tubular anechoic formations within, measuring 21 x 20 × 6 mm. The findings were suggestive of possible duct ectasia classified as Bi-Rads Category 3 with a benign probability. Due to parental concern for increase in size over 2 months, the mass was resected under general anesthesia through a subareolar incision. Microscopic analysis confirmed dilated cystic ducts and an intraductal papilloma with calcifications. The patient recovered well from the operation, and follow-up at nine months, he has experienced no recurrences.

Conclusion

Although rare, this case underscores the importance of including intraductal papilloma in the differential diagnosis of breast nodules in male infants.
8 个月大男婴乳房肿块中出现的导管内乳头状瘤:病例报告
导言导管乳头状瘤在儿科人群中是一种极为罕见的疾病,尤其是在婴幼儿期的男性中,通常在 35 至 55 岁的女性中最为常见,表现为血色或血清样乳头溢液和离散性乳房肿块。本病例中,一名 8 个月大的健康男婴右侧乳晕下乳房肿胀,无触痛,边界清楚,光滑,可移动,呈橡胶样,无任何相关的乳头溢液或区域淋巴结病,临床上直径为 10 × 10 毫米,呈蓝绿色,上覆皮肤无相关变化。超声波检查证实了右侧乳晕后肿块的存在,其特征为多隔复合囊肿样结构,内有管状无回声形成,大小为 21 × 20 × 6 毫米。检查结果提示可能存在导管异位,被归为 Bi-Rads 3 类,良性可能性大。由于父母担心肿块会在两个月内增大,因此在全身麻醉下通过乳晕下切口切除了肿块。显微镜分析证实,囊性导管扩张,导管内乳头状瘤伴有钙化。患者术后恢复良好,9 个月后随访,未见复发。结论虽然罕见,但该病例强调了将导管内乳头状瘤纳入男婴乳腺结节鉴别诊断的重要性。
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来源期刊
CiteScore
0.60
自引率
25.00%
发文量
348
审稿时长
15 days
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