A 41-year-old woman reports intermittent blood-stained discharge from a single duct of the right nipple for three months. There is no palpable lump and the discharge can be reproduced from one pinpoint duct orifice. What is the most likely diagnosis?

• A Fat necrosis
• B Mammary duct ectasia
• C Fibrocystic change
• D Solitary intraductal papilloma ✓

Explanation

D solitary intraductal papilloma is the classic cause of blood-stained or serous discharge from a single duct without a palpable mass, arising from a papilloma within a dilated major duct close to the nipple. Duct ectasia typically produces a thick, green or brown multi-duct discharge in older women and is often accompanied by a subareolar mass or nipple retraction. Fibrocystic change and fat necrosis do not produce single-duct spontaneous bleeding.

Reference: Bailey and Love's Short Practice of Surgery, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.