Nipple neuroma presenting as focal asymmetry: diagnostic challenges and clinical implications at King Salman bin Abdulaziz Medical City

Traumatic neuromas are benign nerve proliferations that arise as reparative responses after injury, rather than true tumors. They are common in extremities and head–neck sites but rarely occur in the breast, particularly within the nipple–areolar complex. We report the case of a 49-year-old woman with persistent nipple discomfort. She denied nipple discharge, bleeding, or trauma. Blood tests revealed mild anemia and reduced potassium. Her history included right breast surgery for abscess drainage 4 years earlier. No personal or family history of breast or ovarian cancer was reported. Imaging suggested a benign lesion, but surgical excision confirmed a nipple neuroma. Grossly, the excised nipple lesion measured 1.4 × 1.2 × 0.6 cm with a firm whitish cut surface. Histopathology showed disorganized fascicles of peripheral nerve fibers within the dermis. This case illustrates diagnostic difficulties and reinforces the importance of distinguishing neuroma from recurrent malignancy.