Leiomyoma of the nipple diagnosed by MRI
A 32-year-old woman visited the surgery outpatient clinic in our hospital with a recently enlarged left nipple with discharge and erosion. The patient has been aware of the asymmetrically prominent left nipple for 6 years.\nShe did not have fever at the time of the visit, and no history of breast trauma. Additionally, there was no family history of breast cancer. On physical examination, she had a 2-cm pinkish superficial nodule in the left nipple-areolar complex. The nodule was firm and quite tender. The remainder of the breast examination revealed no abnormalities. The laboratory findings were normal.\nThe left mediolateral oblique mammogram revealed an enlarged nipple (Fig. ). Ultrasonography of the left breast showed a 2-cm sized well-circumscribed oval hypoechoic mass with posterior acoustic enhancement in the nipple (Fig. a). A Doppler sonogram of the left nipple mass demonstrated increased peripheral blood flow in the mass (Fig. b). No other abnormal findings were seen neither by mammography nor ultrasonography.\nTo exclude abnormalities in the subareolar region since the parenchyma in this patient was extremely dense, breast MRI was performed.\nMRI revealed an oval mass with circumscribed margins in the left nipple-areolar complex. This mass showed intermediate signal intensity on both T2-weighted images (Fig. a) and T1-weighted images (Fig. b). A dynamic MRI study showed a peripheral rim enhancement (Fig. c). The mass in the left nipple-areolar complex had a higher diffusion-weighted imaging (DWI) signal intensity and lower apparent diffusion coefficient (ADC) value than the right nipple (Fig. d). A kinetic curve demonstrated delayed persistent enhancement (Fig. e). No other abnormal findings were observed.\nAn ultrasound-guided core needle biopsy was performed using a 14-gauge needle. The core needle biopsy demonstrated spindle cell proliferation consistent with leiomyoma of the nipple (Fig. ).\nFinally, on the basis of the histopathological and radiological findings, this case was diagnosed as leiomyoma of the nipple.