A rare case of intraductal papilloma with atypical ductal hyperplasia in a male breast: A pathological diagnosis

Male breast cancer is itself a very rare condition and represents 0.5%–1% of all breast cancers diagnosed. Atypical ductal hyperplasia (ADH), intraductal papilloma (IP), and ductal carcinoma in situ are also very rare in a male breast. Only a few cases of ADH with gynecomastia have been reported in English literature until now. Here, we report a rare case of an IP with ADH associated with gynecomastia in an elderly male, who complained of right nipple pain, discharge, and tiny retroareolar mass. Mammography showed a subareolar nodule graded as the Breast Imaging-Reporting and Data System 4B. It is difficult to differentiate, both clinically and radiologically, between benign and malignant papillary lesions and invasive carcinoma, because of the similarity of findings. Hence, any male with palpable unilateral hard fixed lesions in the retroareolar region with complaints of nipple discharge, skin changes, or axillary lymphadenopathy should have a histopathological evaluation.