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[Intraductal metachronic papilloma: Clinical case]
Celeste C Patiño González1, Enrique J RomeroManteola1
1Servicio de Cirugía Pediátrica, Sanatorio Allende.
Insights
Intraductal papilloma, a rare benign breast tumor, can cause gynecomastia and thelorragia in children. Mastectomy is recommended for male patients to ensure diagnosis and treatment.
Area of Science:
- Pediatric Surgery
- Pediatric Oncology
- Surgical Pathology
Background:
- Intraductal papilloma is a rare benign breast tumor, infrequently diagnosed in pediatric patients.
- Gynecomastia and thelorragia (bloody nipple discharge) are key clinical indicators.
- This case highlights the diagnostic and therapeutic challenges in young males.
Observation:
- A 2-year-old male presented with unilateral gynecomastia and thelorragia.
- A left mastectomy was performed, followed by a contralateral right mastectomy at age 4 for recurrent symptoms.
- Pathology confirmed intraductal papilloma, with no malignancy or atypia in either breast.
Findings:
- Intraductal papilloma is exceptionally rare in children, with only 15 cases reported in the literature.
- Ultrasound emerges as the most effective diagnostic imaging modality.
- Surgical management, including mastectomy, is advised for definitive diagnosis and treatment in male pediatric patients.
Implications:
- Early recognition and surgical intervention are crucial for managing pediatric intraductal papilloma.
- Mastectomy provides both diagnostic confirmation and therapeutic resolution in affected male children.
- This case underscores the importance of considering rare diagnoses in pediatric breast conditions.
Introduction:
The association of gynecomastia and bloody nipple discharge (thelorragia) leads us to the diagnosis of intraductal papilloma. This is a very rare benign tumor in children.
Clinical Case:
A 2 year old male child was referred due to gynecomastia and bloody nipple discharge of the left breast. A mastectomy was performed. At the age of 4 he returned with identical symptoms but in the right breast. A right mastectomy was also required. An excellent clinical outcome was present in the follow up. The pathology reported intraductal papilloma with no evidence of malignancy or atypia.
Conclusion:
The intraductal papilloma rarely affects children, there are 15 reported cases. Ultrasound is the most useful diagnostic method. In male patients, mastectomy is recommended to ensure definitive diagnosis and treatment.
