PMC3738360_01
A 32-year-old woman with leiomyoma of the nipple. A left mediolateral oblique mammogram shows an enlarged nipple
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The left mediolateral oblique mammogram revealed an enlarged nipple (Fig. 1).
A 32-year-old woman with leiomyoma of the nipple. (a) Ultrasonography of the left breast shows a well-circumscribed, ovoid, hypoechoic mass with posterior acoustic enhancement of roughly 2 cm in the nipple. (b) A Doppler ultrasound sonogram of the left nipple mass demonstrates increased peripheral blood flow in the mass
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Ultrasonography of the left breast showed a 2-cm sized well-circumscribed oval hypoechoic mass with posterior acoustic enhancement in the nipple (Fig. 2a). A Doppler sonogram of the left nipple mass demonstrated increased peripheral blood flow in the mass (Fig. 2b).
(a) An axial T2-weighted image demonstrates an intermediate signal intensity mass in the left nipple. (b) An axial fat-suppressed T1-weighted image demonstrates an intermediate signal intensity mass in the left nipple. (c) An axial contrast-enhanced T1-weighted image demonstrates a rim-enhancing mass in the left nipple. (d) Diffusion-weighted imaging (DWI) shows a high intensity lesion (arrow), and an apparent diffusion coefficient (ADC) image shows a low signal intensity (arrow) in the nipple. The ADC value was 1.28 x 10-3. (e) The kinetic curve demonstrates delayed persistent enhancement
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This mass showed intermediate signal intensity on both T2-weighted images (Fig. 3a) and T1-weighted images (Fig. 3b). A dynamic MRI study showed a peripheral rim enhancement (Fig. 3c). The mass in the left nipple-areolar complex had a higher diffusion-weighted imaging (DWI) signal intensity and lower apparent diffusion coefficient (ADC) value than the right nipple (Fig. 3d). A kinetic curve demonstrated delayed persistent enhancement (Fig. 3e).
Pathology shows (H&E x40) a well-demarcated tumor consisting of interlacing bundles of smooth muscle cells in the dermis
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The core needle biopsy demonstrated spindle cell proliferation consistent with leiomyoma of the nipple (Fig. 4).  