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Supernumerary nipples

Dr Daniel J Bell ◉ and Dr Avni K P Skandhan ◉ et al.

Supernumerary nipples are a common minor congenital malformation that consists of accessory nipples.

Supernumerary nipples are located along the embryonic milk lines. Ectopic supernumerary nipples are found beyond the embryonic milk lines. In human beings, the embryonic milk line extends from a point beyond the axillae on the arms, down the chest and the abdomen towards the groin, and is generally thought to end at the proximal inner sides of the thighs.When these nipples appear with complete with breast tissue and ducts, they are referred to as polymastia.

On this page:

Article:

Clinical presentation
Pathology
Treatment and prognosis
Related articles
References

Images:

Cases and figures

Clinical presentation

May remain undetected. Occasionally, the supernumerary nipple is noticed when hormonal changes during adolescence, menstruation, or pregnancy cause increased pigmentation, fluctuating swelling, tenderness, or even lactation.

Pathology

Between the fourth and fifth weeks of embryogenesis, an ectodermal thickening forms symmetrically along the ventral lateral sides of the embryo. This epidermal ridge extends from the axillary region to the inner side of the thigh to form the embryogenic milk (or mammary) line. During the second and third embryogenic months, the glandular elements of the breasts are formed near the fourth and fifth ribs, with regression of the rest of the thickened ectodermal streaks. In the case of failure of a complete regression, some foci may remain to result in a supernumerary nipple. This can develop into a supernumerary complete breast (polymastia).

Associations

It is said to be found in association with many syndromes and other conditions

Syndromes

Central nervous system

epilepsy
migraine
neurosis
familial alcoholism
fetal alcohol syndrome
intracranial aneurysm
neural tube defect
developmental delay

Gastrointestinal

Ear, nose, throat and lung

laryngeal web
ear abnormalities
accessory lung lobe

Skeletal

hand malformation
vertebral anomaly
absent rib
coronal suture synostosis
hemihypertrophy
arthrogryposis
microcephaly

Cardiac

conduction defect
bundle branch block
patent ductus arteriosus
congenital heart disease

Treatment and prognosis

Most often no treatment is required; however, a protruding embarrassing supernumerary nipple can be removed surgically, if desired. Removal using liquid nitrogen cryotherapy has also been described.

References

Anatomy: Thoracic

thoracic skeleton
- thoracic cage
  - ribs
    - typical ribs
    - atypical ribs
    - variant anatomy
      - bifid ribs
      - Srb anomaly
  - costal cartilage
  - sternum
- thoracic spine
- articulations
muscles of the thorax
spaces of the thorax
thoracic viscera
blood supply of the thorax
- arteries
  - thoracic aorta (development)
  - pulmonary trunk
    - left pulmonary artery
      - aberrant left pulmonary artery
    - right pulmonary artery
- veins
  - superior vena cava (cavoatrial junction)
  - inferior vena cava
  - coronary veins
    - cardiac veins which drain into the coronary sinus
      - great cardiac vein
      - middle cardiac vein
      - small cardiac vein
      - posterior vein of the left ventricle
      - vein of Marshall (oblique vein of the left atrium)
    - anterior cardiac veins
    - venae cordis minimae (smallest cardiac veins or thebesian veins)
  - pulmonary veins
    - bronchial veins
lymphatics
innervation of the thorax

Article information

rID: 25689

System: Breast

Section: Anatomy

Tag: cases, refs, cases

Synonyms or Alternate Spellings:

Accessory nipples
Accessory nipple
Polythelia
Supranumerary nipple

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