PDF(Pubmed)
Abstract：
A nipple adenoma is an epithelial tumor of the lactiferous ducts, typically affecting women aged 50-60 years old. This case report discusses a 52-year-old woman who developed a papillary adenoma of the right nipple after initiating oral estrogen replacement therapy (ERT) for perimenopausal symptoms. A 4 mm punch biopsy and subsequent immunohistochemistry stain revealed the proliferation of ductal structures consistent with a papillary adenoma and tumor cells expressing estrogen receptors (ER) and progesterone receptors (PR). Despite their benign nature, nipple adenomas may exhibit alterations in immunophenotype, including ER and PR expression, which could lead to potential tumor growth in women undergoing these treatments. This case describes the first reported growth of a nipple adenoma in the context of estrogen replacement therapy, highlighting a potential risk of hormone therapy in promoting hyperproliferation of benign tumors such as nipple adenomas. When utilizing ERT, it is important to weigh the potential advantages and risks, as its application in the management of vasomotor symptoms during menopause may increase the risk of both breast cancer and benign proliferative breast diseases. These considerations underscore the need for individualized therapy when approaching perimenopausal and postmenopausal care.
摘要：
乳头腺瘤是泌乳管的上皮性肿瘤，通常影响50-60岁的女性。该病例报告讨论了一名52岁的女性，该女性在因围绝经期症状开始口服雌激素替代疗法（ERT）后发展为右乳头乳头状腺瘤。4mm穿刺活检和随后的免疫组织化学染色显示，导管结构的增殖与乳头状腺瘤和表达雌激素受体（ER）和孕激素受体（PR）的肿瘤细胞一致。尽管它们是良性的，乳头腺瘤可能表现出免疫表型的改变，包括ER和PR表达式，这可能导致接受这些治疗的女性潜在的肿瘤生长。该病例描述了在雌激素替代疗法的背景下首次报道的乳头腺瘤的生长，强调激素治疗促进乳头腺瘤等良性肿瘤过度增殖的潜在风险。使用ERT时，重要的是要权衡潜在的优势和风险，因为它在绝经期间血管舒缩症状的管理中的应用可能会增加乳腺癌和良性增生性乳腺疾病的风险。这些考虑强调了在进行围绝经期和绝经后护理时需要个体化治疗。
