Sonographic, Microscopic, And Immunohistochemical Features Of Nipple Adenoma Coexisting With Intra-Ductal Papillary Carcinoma: A Rare Case Report

Nipple adenoma is an uncommon benign mammary lesion derived from the lactiferous ducts. This is the first case of nipple adenoma coexisting with intra-ductal papillary carcinoma with sonographic, microscopic, and immunohistochemical analysis. In this report, a case of nipple adenoma coexisting with intra-ductal papillary carcinoma is presented from a 72-year-old female patient. Ultrasonography showed a hyperechoic lesion with abundant blood flow signal in the right papilla. Histologically, there was infiltrating growth or compression deformation of gland ducts in the sub-epithelial stroma. The myoepithelial cells of the gland ducts were p63 positive, CK5/ 6 positive, and smooth muscle actin (SMA) positive. In addition, there was a local lesion of intra-ductal papillary carcinoma. The epithelial cells arranged in papillary shape, and the nuclei of epithelial cells have low or moderate atypia. CK5/ 6 negative, p63 negative; SMA negative; estrogen receptor (ER) and progesterone receptor (PR) heterogeneous positive; Ki67 index was about 70%. The patient was alive with no tumor recurrence during 4 years of postoperative follow-up period. Nipple adenoma coexisting with intra-ductal papillary carcinoma is exceptionally rare. This kind of case is reported based on ultrasonic characteristics, microscopic features, and immunohistochemical testing, which highlights the possibility of nipple adenoma coexisting with intra-ductal papillary carcinoma and provides most effective basis for the diagnosis and treatment of this disease.