Solitary intraductal papilloma
 Discussion of Solitary intraductal papilloma
- Solitary intraductal papillomas are benign lesions
- Most typically occur in women in their late reproductive or postmenopausal years (average age at presentation is 48 years).
- Patients typically report a bloody or clear nipple discharge of less than 6 months duration.
- Solitary intraductal papillomas are 2–3 mm and appear as broad-based or pedunculated polypoid epithelial lesions that may obstruct and distend the involved duct.
- They may cause cysts by obstructing the duct.
- They arise within 1 cm from the nipple in 90% of cases.
- According to a consensus committee of the College of American Pathologists (4), women with this lesion have a 1.5- to 2-times relative risk of developing invasive breast carcinoma in their lifetimes.
- Solitary intraductal papillomas should be distinguished pathologically and clinically from papillomatosis, a condition in which multiple papillomas exist in more than one duct system and which is considered a premalignant condition.
- The treatment for solitary intraductal papillomas is duct excision.
- Given the increased risk of malignancy over a woman's lifetime when this lesion is diagnosed, compliance with screening recommendations for such patients is strongly advisable.
 Imaging Findings for Solitary intraductal papilloma
- Mammograms are most frequently normal.
- When imaging findings are present, they include solitary or multiple dilated ducts, a circumscribed benign-appearing mass, or a suspicious cluster of calcifications.
- Galactography usually reveals a filling defect or other ductal abnormality, such as ectasia, obstruction, or irregularity.
- These findings are nonspecific
- Well-defined, smooth-walled, solid, hypoechoic mass, as in this case, or a lobulated, smooth-walled, cystic lesion with some solid components
- A dilated duct is frequently visible at US.
- The differential diagnosis for this appearance includes other solid tumors that can occur in the large ducts, specifically ductal carcinoma in situ or invasive ductal carcinoma with an in situ component.
- Papillary carcinomas can mimic intraductal papillomas at US.
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 References for Solitary intraductal papilloma
- Etta D. Pisano, M. Patricia Braeuning, and Eithne Burke. Case 8: Solitary Intraductal Papilloma. Radiology 1999 210: 795-798.