A Polypoidal Mass on the Nipple

Polyp on nipple
Source: BMC Research Notes

A 45-year-old woman presented with a lump on her right nipple. It was painless and a pedicle attached it to the woman’s breast. Moreover, there was no history of pregnancy and the breast was otherwise normal.

On clinical examination, the doctors confirmed a well-circumscribed mass. It appeared benign and doctors made differentials of leiomyoma and dermatofibroma. Therefore, doctors opted for a quick surgical excision. They carried out the procedure under general anaesthesia. There were no postoperative complications.

Examination of the Nipple Mass

After excising the pedunculated mass on the woman’s nipple, the doctors sent it for histopathological examination. Macroscopically, it was a polypus covered with skin. However, on microscopic examination, the mass had variable cellularity. It contained fibromuscular tissue in its stalk. Moreover, there were mast cells and giant cells in the stroma too. Overall, the skin lined polyp lacked any kind of necrosis or haemorrhage. Hence, based on these findings, doctors diagnosed it as a fibroepithelial stromal polyp (FESP).

Fibroepithelial Stromal Polyp

Fibroepithelial stromal polyp exhibits variable morphology. It contains a fibrovascular stroma with a multitude of cells ranging from simple mast cells to multinucleated giant cells. Since it can show increased mitotic activity sometimes, it can be mistaken for a neoplasm. However, it usually occurs in the genital area. Our case describes its presentation on the nipple which by all standards is highly rare.


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