Differential Diagnosis for a 15 y/o Male with Painful Lump Palpable Under Nipple
- Single Most Likely Diagnosis
- Gynecomastia: This condition is characterized by the benign enlargement of breast tissue in males, often presenting as a palpable lump under the nipple. It is common during puberty due to hormonal changes, making it the most likely diagnosis in a 15-year-old male.
- Other Likely Diagnoses
- Lipoma: A benign tumor composed of fat tissue, which can occur under the nipple and cause a palpable lump. It's less common than gynecomastia but still a plausible explanation for a lump in this area.
- Sebaceous cyst: A benign, usually painless, lump under the skin that can become painful if infected. While less common under the nipple, it's a possible cause for a painful lump.
- Breast abscess: An infection of the breast tissue, which can cause a painful lump. Though more common in females, especially those who are lactating, it can occur in males, particularly if there's an underlying condition like gynecomastia.
- Do Not Miss Diagnoses
- Testicular cancer with metastasis: Although rare, testicular cancer can metastasize to the breast tissue, presenting as a lump. Given the potential severity of cancer, it's crucial not to miss this diagnosis, despite its low likelihood.
- Breast cancer: While exceedingly rare in males, especially at the age of 15, breast cancer must be considered to avoid missing a potentially life-threatening condition.
- Inflammatory breast cancer: A rare and aggressive form of breast cancer that can cause the breast to look inflamed due to blockage of lymphatic vessels. It's essential to rule out this condition due to its aggressive nature and poor prognosis if not promptly treated.
- Rare Diagnoses
- Hamartoma: A benign growth that can occur in the breast, composed of a mixture of glandular, fibrous, and fatty tissues. It's rare and might present as a lump under the nipple.
- Phyllodes tumor: A rare tumor of the breast that can be benign, borderline, or malignant. It typically presents as a rapidly growing lump but is uncommon in males.
- Dermatofibrosarcoma protuberans: A rare skin cancer that can present as a lump under the skin, including under the nipple, though it's extremely uncommon in this location.