Bloody nipple discharge caused by an intraductal papilloma of the breast in an adolescent girl: A case report

Abstract

Bloody nipple discharge in pediatric patients is rare and mostly associated with benign conditions.Despite the generally benign nature, a thorough investigation of the cause and treatment is required if a palpable lesion is present. Here, the author reports a case of bloody nipple discharge in an adolescent girl with no significant medical history. Breast ultrasound demonstrated a solid, oval-shaped, circumscribed mass in the left subareolar region that was categorized as category 4a according to the breast imaging reporting and data system (BI-RADS). An excisional biopsy and histological examination confirmed a diagnosis of intraductal papilloma. While intraductal papilloma is rare in the pediatric population, ultrasound evaluation and knowledge of characteristic findings are useful for noninvasive diagnostics and image-guided treatment planning.

Keywords: Bloody nipple discharge; Breast; Papilloma; Pediatric; Ultrasound.

Fig. 1

Transverse and longitudinal views of gray-scale ultrasound show a circumscribed, solid mass with heterogeneous internal echotextures (arrowheads) and focal anechoic area (arrow) in the peripheral portion of the mass (A, B), and color Doppler sonography demonstrates increased intralesional vascularity (C). On shear wave elastography, the mass showed intermediate elasticity (D)

Fig. 2

Excised specimen reveals an intraductal papillary proliferating mass (hematoxylin and eosin(H & E) scan view) (A). On H & E x4 objective, the mass reveals columnar cell hyperplasia with proliferations and myxoid change (B)