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Case Reports
. 2019 Jul;40(4):269-272.
doi: 10.4082/kjfm.17.0143. Epub 2018 Nov 29.

Mammary Paget's Disease of the Nipple: Relatively Common but Still Unknown to Many

Poh Siang Ooi  1 , Nani Draman  1 , Siti Suhaila Mohd Yusoff  1 , Wan Zainira Wan Zain  2 , Dharmendra Ganasagaran  2 , Hui Heng Chua  3
Affiliations
Case Reports

Mammary Paget's Disease of the Nipple: Relatively Common but Still Unknown to Many

Poh Siang Ooi et al. Korean J Fam Med. 2019 Jul.

Abstract

Mammary Paget's disease is clinically defined as skin inflammation of the nipple area and is an adenocarcinoma of the epidermis of the nipple. The pathogenesis of mammary Paget's disease is relatively unknown; nonetheless, there are two popular theories that support the underlying carcinoma and de novo carcinogenesis. For the attending medical practitioner, mammary Paget's disease poses a diagnostic and therapeutic dilemma, especially in the absence of a clinically palpable breast mass. We report a rare case of a 48-year-old Malay woman who presented at Hospital Universiti Sains Malaysia, Kelantan, Malaysia with the symptom of skin erosion on the left nipple and unresponsiveness to multiple topical treatments. A full evaluation and assessment of the patient were conducted, and mammary Paget's disease was diagnosed.

Keywords: Breast Neoplasms; Eczema; Mammary Paget’s Disease; Nipples.

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Conflict of interest statement

No potential conflict of interest relevant to this article was reported.

Figures

Figure. 1.
Figure. 1.
(A, B) The left nipple was eroded from the center, extending to the lateral side.
Figure. 2.
Figure. 2.
(A–D) Mammography of the left breast (LCC and LMLO) shows highly pleomorphic calcification with a casting pattern, with regional distribution in the left retro-areolar region with no focally dominant lesion BIRADS (Breast Imaging Reporting and Data System) V. LCC, left craniocaudal view; LMLO, left mediolateral oblique view; RCC, right craniocaudal view; RMLO, right mediolateral oblique view.
Figure. 3.
Figure. 3.
(A) Section shows the epidermis of the nipple infiltrated by large Paget’s cells, which are singly dispersed exhibiting pleomorphic vesicular nuclei with prominent nucleoli and pale cytoplasm (×200, arrows). (B) The tumor cells were positive for c-erbB-2 immunohistochemical staining (×200).
See this image and copyright information in PMC

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