Two Cases of Supernumerary Nipple.

Lee, Jeong Woo; Yang, Jung Dug; Lee, Jung Hun; Choi, Kang Young; Kim, Gui Rak; Chung, Ho Yun; Cho, Byung Chae

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Case Report

Journal of the Korean Society of Plastic and Reconstructive Surgeons 2010;37(5):695-698.
Published online September 1, 2010.

Two Cases of Supernumerary Nipple.

Jeong Woo Lee, Jung Dug Yang, Jung Hun Lee, Kang Young Choi, Gui Rak Kim, Ho Yun Chung, Byung Chae Cho

Department of Plastic and Reconstructive Surgery, School of Medicine, Kyungpook National University, Daegu, Korea. lambyang@paran.com

Abstract

PURPOSE
Supernumerary nipple or polythelia is one of the developmental anomalies occurring at the embryonic stage and this anomaly usually arises from the milk line. While this atypical feature is determined during early developmental stage, it may not come out obviously or become troublesome until puberty or lactation. Moreover, sometimes it is confused with a pigmented nevus. METHODS: Case 1, a 18-year-old woman with intramammary supernumerary breast consisted of another nipple with middle sized areola on the right lower breast was admitted for a 2.8 x 3.1 cm-sized mass on the right breast which was starting appeared 1 year earlier. The preliminary cytological examination of the material obtained by needle aspiration biopsy from the mass was revealed by fibroadenoma with no malignant change. The patient had the surgical excision of the mass and accessory breast. Case 2, a 16 year-old woman admitted for intra-areolar polythelia of the left breast, even she doesn't have any family history of polythelia. Since she wanted surgical correction of her atypical nipple for aesthetic and psychological reasons, we reconstructed the areola using transposition flaps in an S-plasty design.
RESULTS
Case 1, the excised supernumerary nipple showed following histological features. In the superficial layer, an acanthotic and hyperpigmented epithelium with elongated rete ridges was found. In the dermis, there were follicles with hairs surrounded by hypertrophic sebaceous glands. In the deepest portion, abundant secretory glomerules and excretory ducts of apocrine gland type were observed. Case 2, follow-up visits 3 months after the procedure showed a satisfactory result with good shape and projection of the nipple.
CONCLUSION
We report two cases of aberrant mammary tissue who underwent surgical correction, including complete breast (with nipple, areola, and glandular tissue) and intra-areolar polythelia according to the Kajava's classification, and the results were satisfactory.

Keywords: Intra-areolar; Polythelia; Supernumerary nipple

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