intracystic papillary adenoma

Intracystic Papillary Adenoma: A Rare Breast Tumor

Intracystic papillary adenoma (IPA) is a rare type of breast tumor that arises within a cystically dilated duct. It is characterized by a papillary epithelial neoplasm that grows inside the duct, often accompanied by a thick fibrous capsule.

Key Features:

• Papillary architecture: The tumor consists of papillae lined by neoplastic epithelium, which can be low to intermediate nuclear

Intracystic papillary adenomas, also known as encapsulated papillary carcinomas (EPC), are rare breast tumors that can cause a range of symptoms.

Common signs and symptoms:

• A palpable mass or lump in the breast, which may be slow-growing and painless [5]
• Bloody nipple discharge, although this is not always present [11]
• Abnormal mammogram or ultrasound findings, such as a cystic mass with septations [8]
• Asymptomatic women may also be diagnosed incidentally on imaging tests [9]

Other possible symptoms:

• Swelling in the breast tissue
• Inverted nipples
• Pain in the breast or chest area
• Changes in breast size or appearance

It's essential to note that not all intracystic papillary adenomas will exhibit these symptoms, and some women may be diagnosed incidentally on imaging tests. If you're experiencing any unusual breast changes or symptoms, it's crucial to consult with a healthcare professional for proper evaluation and diagnosis.

References: [5] by J Kulka · 2022 · Cited by 56 — EPC usually presents as a slowly growing, indolent palpable mass with bloody discharge in postmenopausal women, rarely in men. [8] Aug 13, 2021 — The usual ultrasound appearance is a cystic mass, with or without septations, with solid papillary masses projecting into the cyst lumen. [9] by DL Nuñez · 2020 · Cited by 15 — Common symptoms include palpable masses and nipple discharge, although it is not uncommon for papillary lesions to be diagnosed in asymptomatic women or on ... [11] Papillomas might cause symptoms such as clear or bloody nipple discharge (or a breast lump), or they might show up as an abnormal area on an imaging test (such as a mammogram or breast ultrasound).

Intracystic papillary adenoma, also known as encapsulated papillary carcinoma (EPC), can be challenging to diagnose due to its rarity and similarity in appearance to benign lesions. However, various diagnostic tests can help establish a diagnosis.

• Mammography: A mammogram may show a well-circumscribed mass with a thin wall, but it is not specific for intracystic papillary adenoma [10].
• Ultrasound scan: An ultrasound scan can reveal a cystic lesion with a solid component or a complex mass with multiple septations, which may suggest an intracystic papillary adenoma [9].
• Core needle biopsy: Core needle biopsy is considered the gold standard for diagnosing intracystic papillary adenoma. It involves removing a small sample of tissue from the lesion and examining it under a microscope [5]. The biopsy can show characteristic features such as arborizing thin and delicate fibrovascular cores covered by neoplastic epithelium, often low to intermediate nuclear grade [2].
• Fine needle aspiration (FNA): FNA is another diagnostic tool that involves inserting a small needle into the lesion and removing a sample of cells for examination. However, FNA may not always provide a definitive diagnosis due to the potential for sampling error [9].
• MRI: Magnetic resonance imaging (MRI) can be useful in establishing the extent of the lesion and planning surgical excision [5].

It's worth noting that the diagnosis of intracystic papillary adenoma often relies on pathologic examination, and a combination of these diagnostic tests may be necessary to establish an accurate diagnosis.

References: [1] - Not available in context [2] - Context 2 [3] - Not available in context [5] - Context 5 [9] - Context 9 [10] - Context 10

Based on the search results, it appears that there is limited information available on the drug treatment of intracystic papillary adenoma (IPC). However, I can provide some general information on the topic.

Surgical excision remains the mainstay of treatment: According to search result [9], surgical excision remains the mainstay of treatment for adenocarcinomas of the main duodenal papilla, which is a similar condition to IPC. This suggests that surgery may also be the primary treatment option for IPC.

Chemotherapy and hormone therapy may be considered: Search result [2] mentions that chemotherapy and hormone therapy may be considered in some cases of breast cancer, including IPC. However, it does not provide specific information on the use of these treatments for IPC.

Targeted therapy and bisphosphonates may also be used: Search result [4] lists targeted therapy and bisphosphonates as potential treatment options for breast cancer, which may include IPC.

It's worth noting that IPC is a rare condition, and there may not be much information available on its specific treatment. Further research or consultation with a medical professional would be necessary to determine the best course of treatment for an individual case.

References:

• [9] Aug 10, 2020 — Surgical excision remains the mainstay of treatment of adenocarcinomas of the main duodenal papilla in patients who are a good surgical risk ...
• [2] by M Khan · 2023 · Cited by 1 — 83% of patients with IDC stage 3 received chemotherapy whereas, only 45.3% with IPC received chemotherapy.
• [4] Radiotherapy; Hormone therapy; Chemotherapy; Targeted therapy; Bisphosphonates. These treatments aim to reduce the risk of breast ...

The differential diagnosis of intracystic papillary adenoma (also known as intracystic papillary carcinoma) involves a range of conditions that can present with similar clinical and histopathological features. Some of the key entities to consider in the differential diagnosis are:

• Intraductal Papilloma: A benign tumor that arises within the ducts of the breast, often presenting as a small, solitary lesion.
• Atypical Ductal Hyperplasia (ADH): A condition characterized by abnormal cell growth within the ducts of the breast, which can be a precursor to invasive cancer.
• Invasive Adenocarcinoma: A type of breast cancer that has spread beyond the ducts and into surrounding tissues.
• Papillary Lesions: A group of conditions that include intraductal papilloma, atypical papilloma, carcinoma arising in a papilloma, and other rare entities.

According to [10], fibroadenomas are the largest single cause of equivocal diagnoses on fine-needle aspiration (FNA) specimens from the breast. Other lesions that can be considered in the differential diagnosis include intracystic papillary carcinoma, solitary intraductal papillomas, and atypical ductal hyperplasia (ADH).

In addition to these entities, [13] notes that papillary lesions of the breast comprise a heterogeneous group of diseases ranging from benign and atypical lesions to malignant tumors. The differential diagnosis can be challenging due to overlapping features between these conditions.

The key points to consider in the differential diagnosis of intracystic papillary adenoma are:

• Clinical presentation: A solitary, circumscribed mass or cystic lesion in the breast.
• Histopathological features: Papillary architecture with a fibrous wall and tall columnar cells within the lumen.
• Imaging findings: A round or oval circumscribed mass on mammography.

It is essential to consider these factors when differentiating intracystic papillary adenoma from other conditions, such as intraductal papilloma, ADH, invasive adenocarcinoma, and other rare entities.