Mystifying Fibroepithelial Stromal Polyps of the Breast Nipple: A Report of Three Rare Cases and a Literature Review.

Fibroepithelial stromal polyps (FEPs) or acrochordons of the breast nipple are seldom encountered benign tumors with mesoderm origin. These FEPs are frequently reported along the skin folds in the form of either skin-colored, tan, or hyperpigmented pedunculated or sessile papule-like or polypoidal growths. Three adult female patients presenting to a tertiary care hospital underwent surgical excision of nipple growth. All three cases had local presentation ranging from asymptomatic growth to one with tenderness alone and another with tenderness, pruritis, and scant nipple discharge. Although all three had varied provisional clinical diagnoses, after histopathological examination, the final diagnosis of FEP of the breast nipple was confirmed in all three cases. FEPs of nipple share histomorphological features with FEPs occurring at other common sites, with variably cellular, abundant fibrovascular and collagenous stroma covered by epithelium lining. The presence of nuclear pleomorphism and increased mitosis can lead to significant confusion with benign and malignant primary breast pathologies. On six months post-excision follow-up, none of the three patients reported any fresh complaints. The findings of this short case series highlight the need for awareness, the importance of early diagnosis, and potential clinical mimics in these cases.