Intraductal papilloma of the male breast: a case report and review of the literature

Abstract

Intraductal papilloma is a benign neoplasm rarely found in the male breast. In this report, we present the case of a 55-year-old Caucasian man who presented with spontaneous bloody nipple discharge of the right breast. Ultrasonic and mammographic investigations revealed a sub-centimetre solid mass within a dilated duct. He underwent a total duct excision. Histopathologic examination confirmed a benign intraductal papilloma with no evidence of atypia or malignancy. A systematic review of the literature revealed six published cases of intraductal papillomas in men. Clinical presentation is the same as in women with single duct blood stained discharge being the most common presenting symptom. Surgical excision offers both histologic confirmation and definitive treatment. There is one case where the lump was not removed and progressed to malignancy years later. Male intraductal papillomas may be associated to medical treatments with hormonal activity given for other reasons or endocrine abnormalities.

Figure 1:

Single duct nipple discharge in a man.

Figure 2:

Ultrasonographic appearance of the papilloma within a duct.

Figure 3:

Partially dilated duct with papillary projections within its lumen (in the right side of it) (H+Ex400).

Figure 4:

The same duct with the papillary projections. The wall is fibrotic and there are also foci of usual type of epithelial hyperplasia (H+E×100).

Figure 5:

Immunohistochemistry with CK14 demonstrates the myoepithelial cells in the papillary structures (CK14×200).