Unilateral Giant Seborrheic Keratosis of the Nipple–Areola Complex in a Young Woman: A Case Report

TL;DR

A young woman had a rare seborrheic keratosis on her nipple-areola complex, which was correctly diagnosed as benign after thorough testing.

Contribution

This case report highlights seborrheic keratosis as a rare but important differential diagnosis for nipple-areola lesions in young patients.

Findings

A 36-year-old woman presented with a pigmented lesion on the nipple-areola complex, which grew during pregnancies.

Histopathological analysis confirmed the lesion was a benign seborrheic keratosis, not a malignancy.

The case emphasizes the need for histopathological evaluation to avoid misdiagnosis in similar presentations.

Abstract

Seborrheic keratosis is a common benign epidermal tumor that affects individuals of various ages and may arise on both sun-exposed and non-sun-exposed areas. Involvement of the nipple-areola complex is rare and may pose a diagnostic challenge due to its clinical resemblance to malignant or premalignant breast conditions, particularly Paget disease of the breast. We report the case of a 36-year-old woman who presented with a long-standing, progressively enlarging unilateral pigmented verrucous lesion involving the left nipple-areola complex, with onset and marked growth during two consecutive pregnancies. Clinical examination, dermoscopic evaluation, and breast imaging were performed, followed by histopathological analysis, which confirmed the diagnosis of acanthotic, pigmented seborrheic keratosis without evidence of malignancy. Given the benign nature of the lesion and patient preference, conservative management was selected with close dermatologic follow-up. This case highlights the importance of considering seborrheic keratosis in the differential diagnosis of nipple-areola lesions, even in young patients, and underscores the essential role of histopathological examination in establishing an accurate diagnosis and guiding individualized management.

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