Case Report and Literature Review of Nodular Hiradenoma, a Rare Adnexal Tumor That Mimics Breast Carcinoma, in a 20-Year-Old Woman

Vanya Jaitly, MD; Richard Jahan-Tigh, MD, MS; Tatiana Belousova, MD; Hui Zhu, MD, PhD; Robert Brown, MD; Karan Saluja, MD


Lab Med. 2019;50(3):320-325. 

In This Article

Clinical Presentation

A 20-year-old Hispanic/Latino woman with no significant past medical history presented at our institution, The University of Texas Health Science Center McGovern Medical School in Houston, TX, with a mass in her right breast mass that had been present for 1 year. The mass had started to grow in size during the past few weeks, causing pain with overlying skin ulceration and serosanguinous discharge; the discharge had been drained at an outside hospital. A biopsy of the right breast mass was performed at the outside institution and was forwarded to our institution because it suggested a possible diagnosis of breast carcinoma.

On presentation to our institution, we noted a subcutaneous palpable mass (4.0 × 3.0 cm) in the upper outer quadrant of the right breast, with ulceration of the overlying skin (Image 1). Ultrasonographic imaging showed a 5.0 × 4.0 × 3.3–cm mass at the 10-o'clock position with solid and cystic components, with an increased vascularity in the solid component. Radiologically, the differential diagnosis included abscess or breast neoplasm with superimposed infection. A sentinel node was identified on lymphoscintigraphy.

Image 1.

Tumor mass in the upper outer quadrant of the right breast with ulceration and serosanguinous discharge.