Juvenile intraductal papilloma mimicking cystic lymphangioma on ultrasonography in a child: a case report.
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INTRODUCTION AND RATIONALE: Juvenile intraductal papilloma is a rare benign breast lesion and an uncommon cause of bloody nipple discharge in children. Its rarity, particularly in males, and its resemblance to other benign breast lesions may lead to diagnostic uncertainty. We present a case of juvenile intraductal papilloma in a 4-year-old boy to highlight its inclusion in the differential diagnosis of pediatric breast masses and the importance of histopathological evaluation for definitive diagnosis. CASE PRESENTATION: A 4-year-old boy presented with painless unilateral breast swelling and bloody nipple discharge. Ultrasound showed a non-vascular cystic retro-areolar lesion. Surgical excision was performed, and histology confirmed juvenile intraductal papilloma with no evidence of malignancy. DISCUSSION: Juvenile intraductal papilloma is a rare cause of bloody nipple discharge in children and may mimic other benign breast lesions on imaging. In this case, ultrasonography suggested cystic lymphangioma, whereas histopathological examination established the diagnosis of juvenile intraductal papilloma. Furthermore, the presence of a palpable retro-areolar mass highlights the importance of considering surgical excision and tissue diagnosis in selected atypical presentations. CONCLUSION: Bloody nipple discharge in children is rare and usually benign, most often due to mammary duct ectasia. While conservative management is standard, persistent discharge with a palpable mass requires careful evaluation. This case demonstrates an uncommon juvenile intraductal papilloma and supports selective surgical excision when clinically indicated.