World Journal of Oncology, ISSN 1920-4531 print, 1920-454X online, Open Access
Article copyright, the authors; Journal compilation copyright, World J Oncol and Elmer Press Inc
Journal website https://www.wjon.org

Case Report

Volume 13, Number 4, August 2022, pages 235-240

Syringomatous Tumor of the Nipple

Figures

Figure 1.
Figure 1. A 40-year-old woman with 2-year history of pain and right nipple enlargement. (a) Macroscopic findings of the nipples. Note the deformity and enlargement of the right nipple compared to the normal left nipple.
Figure 2.
Figure 2. (a) Mammography of the right breast. No retro-areolar calcifications nor abnormalities were seen on regular or magnified views. (b) Ultrasonography of the right nipple. No retro-areolar masses or abnormalities were seen.
Figure 3.
Figure 3. Post-contrast T1-weighted fat-suppressed axial MRI images, with subtractions on the left, show asymmetric enhancement of the right nipple (arrows) compared to the left (curved arrows). MRI: magnetic resonance imaging.
Figure 4.
Figure 4. (a) At low power, superficial keratin-filled cysts are seen (H&E stain, × 20). Deeper in the dermis is an infiltrative proliferation of small epithelial clusters and cords that extend down to the adipose tissue below. This configuration is similar to microcystic adnexal carcinoma, a sweat gland tumor usually seen on skin of the head and neck. (b) Many of the cellular clusters have a syringoid ductal appearance. They are seen infiltrating around and through bundles of dermal smooth muscle (H&E stain, × 200). (c) At high power the ducts have a uniform and cytologically bland cuboidal luminal layer (arrow), and a peripheral outer layer of flattened basal cells is frequently identified (H&E stain, × 600). (d) P40 immunohistochemical stain. The intact basal cell layer (arrow) is highlighted by p40 immunohistochemical stain (× 600). H&E: hematoxylin and eosin.

Table

Table 1. Seventeen Cases of SAN Reported in the Literature Since 2004
 
CaseAuthorAge (years)SexLocationClinical Exam FindingsSize (cm)Surgery
SAN: syringomatous adenoma of the nipple; F: female; M: male; L: left; R: right; NR: not revealed.
1Carter et al, 2004 [5]23FUnilateralErythematous, tender right nipple nodule with thick, white material extruding from nipple under pressure3.5Local excision
2Yosepovich et al, 2005 [13]33FUnilateralLeft nipple massNRExcisional biopsy
3Oliva et al, 2008 [14]32FUnilateralMarkedly deformed nipple-areolar complex with underlying mass effect4Central mound excision with a transposition flap closure
4Riaz et al, 2008 [15]39FUnilateralNot availableNRSurgery
5Page et al, 2009 [9]40FSupernumerary breastEnlargement of supernumerary breast with milk production postpartumNRPunch biopsy
6Sharma et al, 2009 [16]32FUnilateralIll-defined, indurated, non-tender subcutaneous nodule within areolar region0.5Complete excision
7Odashiro et al, 2009 [17]44FUnilateralIrregular nodule on nipple area with edema0.75Complete excision
8Kim et al, 2010 [18]48FUnilateralNo abnormal findings on bilateral breastsNRLocal excision
9Mrklic et al, 2012 [8]58FBilateralBilateral mastopathyNRBilateral wide excision
10Zhong et al, 2013 [10]33FUnilateralHard, non-tender subcutaneous nodule within the areolar region and associated nipple inversion3Local excision
11AlSharif et al, 2014 [19]39FUnilateralNon painful nipple enlargementNRLocal excision
12Montgomery et al, 2014 [7]71FBilateralL: fungating massL: 4.2L: total mastectomy
R: unremarkableR: needle-localized excisional biopsy
13Ishikawa et al, 2015 [11]41FUnilateralNR7Local excision
14Abeciunas et al, 2020 [12]FUnilateralTender, firm solid nodule with deformation of left nipple-areolar complex5Local excision
15Zhu et al, 2020 [20]41FUnilateralEnlarged, hardened right nippleNRLocal excision of nipple-areolar complex
16Niakan et al, 2021 [21]35FUnilateralInverted nipple with firm subareolar tissueNRLocal excision
17Paramaguru et al, 2021 [6]43MUnilateralPalpable, non-tender, firm mass beneath nipple-areolar complex with nipple retraction2Wide local excision