Abstract
Objective: To report the case of a 20-year-old female patient with an unusual presentation of soft nipple fibroma as well as its surgical excision with confirmation of the diagnosis by histopathology, also reviewing all cases of soft nipple fibroma so far published. Case details: Female, 20 years old, with a pedunculated, soft and painless lesion on the left nipple with insidious growth since she was six years old. Tangential surgical excision and histopathological examination were performed with findings of irregular acanthosis, hyperkeratosis, papillomatosis, dermis with connective tissue with loose collagen fibers and numerous capillaries with discrete mononuclear infiltrate, evidencing the diagnosis of soft fibroma. Final considerations: Soft nipple fibroma is a rare benign lesion that usually evolves well after surgical treatment. To date, there are few publications of soft fibroma with this location. Even though it is a benign skin neoplasm, soft fibroma can cause local pain due to trauma in the region, blisters due to local friction and decreased self-esteem when related to aesthetic issues and personal acceptance.
References
AKPINAR F and DERVIS E. Association between acrochordons and the components of metabolic syndrome. Eur J Dermatol, 2012; 22(1): 106-10.
ANSARI MS, et al. Dermoscopy of nipple adenoma. Clin Case Report, 2020; 8:3253–3255.
ARORA BK. A clinical case of large fibroepithelial polyp of breast nipple. International Journal of Case Reports and Images, 2019: 10.
BANIK R and LUBACH D. Skin tags: localization and frequencies according to sex and age. Dermatologica, 1987; 174: 180-183.
BELLI AK, et al. Fibroepithelial Polyp of the Nipple in a Woman. The Breast Journal, 2013; 19: 111-112.
BEER T, et al. Tumors of Fibrous Tissue Involving the Skin. In: Elder D, et al. Lever’s Histopathology of the Skin. 11th edition. Philadelphia: Wolters Kluwer; 2015; 2786-2885.
COSTA AL, et al. Mammary skin tag in a 2-year-old girl: a long-lasting adnexal polyp of neonatal skin? Pediatric Dermatology; 2009; 26(5): 618-620.
DENNIS MA, et al. Incidental Treatment of Nipple Discharge Caused by Benign Intraductal Papilloma Through Diagnostic Mammotome Biopsy. American Journal of Roentgenology. 2000; 174: 1263-1268.
ELDER DE, et al. Fibroepithelial polyp. In: Atlas and Synopsis of Lever's Histopathology of the Skin. 2 ed. Philadelphia: Lippincott Williams & Wilkins; 2007: 65–6.
ELDER DE, et al. Outline of Cutaneous Pathology. In: Atlas and Synopsis of Lever's Histopathology of the Skin. 2 ed. Philadelphia: Lippincott Williams & Wilkins; 2007: 238-355.
GOULD BE, et al. Lack of association between skin tags and colon polyps in a primary care setting. Arch Intern Med. 1988; 148: 1799–800.
HIGAKY Y, et al. Blister Formation over a Soft Fibroma of the Nipple. The Journal of Dermatology, 1993; 20: 447-448.
HUGHES EJ, et al. Symptomatic fibroepithelial polyp of the nipple in a pediatric patient. Journal of Pediatric Surgery Case Reports, 2022; 76: 102-107.
IM B, et al. Imaging Findings of Soft Fibroma of the Nipple: Two Case Reports. J Korean soc Radiol, 2018; 79(3): 123-128.
KIM JG, et al. Pyriform-shaped soft fibroma of the nipple in a male patient. The Breast Journal, 2018; 24(5): 827.
KIM S and YAUN J. Fibroepithelial polyp of the nipple. Consultant, 2018; 58(1): 46-48.
SIM JH, et al. Verrucous epidermal nevus successfully treated with photodynamic therapy. European Journal of Dermatology, 2010; 20: 814-5.
MINISTÉRIO DA SAÚDE. Coordenação Nacional de Dermatologia Sanitária. Legislação sobre o Controle de Doenças na Área de Dermatologia Sanitária. Brasília; 1992.
NAKAI N, et al. Skin tag of the nipple with blister formation: Two case reports. The Journal of Dermatology, 2013; 40(11): 946-947.
NASRI S, et al. Imaging appearance of isolated diffuse neurofibroma of nipple areolar area: a case report. PAMJ, 2021; 39(178).
PRIETRO VG and REED RJ. Tumors of Neural Tissue. In: Elder D, et al. Lever’s Histopathology of the Skin. 11th edition. Philadelphia: Wolters Kluwer; 2015. 3188-3189.
SEO BF and JUNG S. Fibroma of the Nipple. The Breast Journal, 2012; 18(5): 494-495.
SHABAAN AM, et al. An unusual case of a large fibroepithelial stromal polyp presenting as a nipple mass. BMC Research Notes, 2013; 6: 345.
SOCIEDADE BRASILEIRA DE DERMATOLOGIA. Perfil nosológico das consultas dermatológicas do Brasil. An Bras Dermatol, 2006; 81: 549-58.
VAGHOLKAR K, et al. Pedunculated Fibroma Of The Nipple; Case Report And Review Of The Literature. The Internet Journal of Oncology, 2013; 9: 1-2.
VERMA SB. Giant fibroepithelial polyp of the nipple with dermatitis neglecta. J Cutan Aesthet Surg, 2022; 15: 204-206.
WALDMAN RA, et al. Skin diseases of the breast and nipple: Benign and malignant tumors. J AM Acad Dermatology, 2019.
WALLS SP, et al. Large Fibroepithelial Stromal Polyp of the Breast Nipple. Cureus, 2022; 14(6): e26397.
XU X, et al. Diseases Caused by Viruses. In: Elder D, et al. Lever’s Histopathology of the Skin. 11th edition. Philadelphia: Wolters Kluwer; 2015; 1878-1890.
YOU HS, et al. A Case of Soft Fibroma of the Nipple with a Cauliflower-Like Appearance. Ann Dermatol, 2015; 27: 102-103.
YUCUMÁ D, et al. Soft fibroma of the nipple: Clinical and histopathological characteristics. Rev Senol Patol Mamar, 2020; 34: 60-61.
