Large Fibroepithelial Stromal Polyp of the Breast Nipple

Abstract

Fibroepithelial stromal polyps (FEPs) are benign tumors of the integumentary system with mesodermal origin. They are commonly found over the skin. Rarely, they can be found in the nipple. We report a case in a 62-year-old female with a large FEP emerging from the left breast nipple. It started as a "mole" 10 years ago and slowly progressed in size. The patient did not complain of pain but did report occasional bloody discharge. She has no family history of breast cancer. On physical exam, a pedunculated large polyp, with rubbery consistency, emerging from the left nipple was noted. The lesion consisted of hyper-pigmentation with scattered ulcerations and cauliflower-like growth. Surgical excision was performed and histopathologic analysis showed extensive fibrovascular tissue with dense collagen fibers deposition consistent with FEP. Surgical treatment is curative with minimal skin deformity. In order to make the diagnosis and exclude malignancy, histopathology is mandatory.

Keywords: acrochordon; benign tumor; breast cancer; fibroepithelial polyps; polyp.

Figure 1. Large pendulous polyp lesion with fibroelastic consistency, short pedunculated emerging from the left nipple. Note areas of superficial erosion.

Figure 2. Histopathologic H&E stain 100x showing extensive fibrovascular tissue with dense collagen fibers (black circle) surrounded by a hyperplastic epidermis (black arrows).