Syringomatous adenoma of the nipple--treatment by central mound resection and oncoplastic reconstruction

Syringomatous adenoma (SA) of the nipple is a rare tumor first described by Rosen in 1983. It is histologically similar to skin adnexal tumors in other parts of the body. It has been reported under several names including low-grade adenosquamous carcinoma, SA of the nipple, and infiltrating SA of the nipple. Clinical examination and mammographic evidence yield high suspicion for carcinoma and often these lesions are misdiagnosed. Because the lesion involves the nipple, surgical treatment has ranged from local excision to mastectomy. There are 31 cases reported in the English literature, and although they all recommend complete excision, none describe reconstructive efforts. This case report describes a case of SA of the nipple presenting as a chronic abscess. We discuss the surgical treatment including reconstruction after central mound resection as well as pathological findings.