HISTORY
The patient is a 51-year-old woman with a 1 year history of spontaneous yellow discharge from the nipple
of her left breast. The discharge had increased in volume during the year. The findings from the physical
examination were unremarkable apart from the discharge, which could be readily elicited by pressing on a
point at about 9 o’clock in the subareolar region of the left breast.

IMAGING FINDINGS
Figures 1 is a mammogram images performed acquired on the standard cranio-caudal plane.
It show a breasts with fibro-fat structure ; the fibrous residue are in retro-areolar region and in upperouter
quadrant. No evidence of abnormalities.

Figures 2A, 2B sonogram obtained with a 7.5-MHz linear transducer in the transverse plane of the
subareolar region. They show a dilated tubular structure with a solid mass within it just behind the nipple.

These findings is the hallmark of a dilated duct with an intraluminal mass like in intraductal papilloma.
Figure 2B shows duplex Doppler images of the left subareolar region. In this images we can notice the focal
increase in flow within the mass.

Figure 3A, 3B, 3C, 3D MRI was performed using a 3-T magnet (Magnetom Avanto, General Electric Medical
Solution, Erlangen, Germany) with a dedicated bilateral breast surface coil with prone position. Then,
contrast-enhanced dynamic imaging was performed with an injection of 20 mL of gadopentetate
dimeglumine (Magnevist, Berlex Laboratories, Wayne, NJ, USA); five sequential contrast-enhanced images
were aquired at every 1 min dynamic contrast breast MRI subtraction 1 minute (1), 3 minutes (2), 5
minutes (3) images.

The mass showed lobulated shape, and smooth margin characterized by early and heterogeneous
enhancement and by delayed wash out (time-intensity curve of type II ).
The core biopsy and excision were done, and pathologic result was intraductal papilloma.