Intraductal papilloma

What it is

An intraductal papilloma is the growth of a papilloma inside a single duct: a villous lesion composed of a fibrovascular core covered by a double layer of epithelium. It may be single or multiple.

How it presents

It presents with spontaneous blood-stained or watery nipple discharge from a single duct, and it is unilateral. A retro-areolar mass may be palpable, though no palpable mass may be felt at all.

The pair to hold is what the discharge looks like: bloody discharge points to intraductal papilloma, cheesy discharge to duct ectasia.

How it is diagnosed

Diagnosis is imaging plus a true cut biopsy to confirm it, and the lesion sits at BIRAD 3. Mammography may be negative while US shows an internal mass. The test that is specific for intraductal papilloma is the ductogram, also called a galactogram.