Intraductal Papilloma of Breast

Key Clinical MessageLong-standing breast masses with cystic morphology and skin changes may still represent benign pathology.Giant intraductal papillomas can clinically mimic malignancy; therefore, appropriate imaging, histopathological evaluation, and complete surgical excision are essential for accurate diagnosis and optimal management. Case DescriptionA 54-year-old postmenopausal woman presented with a painless lump in the right breast that had been progressively increasing in size over 7 years.On clinical examination, a well-defined, non-tender mass measuring approximately 6 cm × 5 cm was noted in the upper outer quadrant of the right breast.The overlying skin demonstrated tethering with a bluish discoloration.No ulceration or inflammatory changes were observed (Figure 3).Ultrasonography demonstrated a large cystic lesion with an echogenic mural nodule measuring 181 mm × 181 mm (Figure 2).The patient subsequently underwent wide local excision.Gross examination revealed a cystic lesion measuring 6cm × 6 cm × 2 cm containing a polypoidal nodule arising from the cyst wall and protruding into the lumen, with slit-like spaces and focal hemorrhagic areas (Figure 1).