1/47. Mammary Paget's disease with acantholytic features and without any detectable breast tumor.Paget's disease is usually associated with an underlying adenocarcinoma of the breast. The initial manifestation is an eczematous or psoriasiform lesion of the nipple, soon extending to the mammary areola and then to the surrounding skin. The histology of the lesions is characterized by the presence, within the epidermal layer, of the so-called Paget's cells, i.e. large cells with vesicular nucleus and clear cytoplasm. The authors report a recent case of Paget's disease of the breast in a 75-year-old woman, unusual both for clinical course and observed histology. As for the clinico-evolutive aspects, although in the case observed the initial skin lesions appeared 20 years before, the different diagnostic procedures repeatedly performed showed no evidence in this patient of an underlying adenocarcinoma. The histologic aspect, on the other hand, was peculiar since the typical characteristics of an acantholytic disease were evident. The presence of intraepidermal cleavages with lost, at times, of the normal contacts among the cells of the Malpighian layer has been described only once in Paget's disease. This fact caused some diagnostic difficulties: however, the typical finding of the Paget cells, their positivity to histochemical methods such as cytokeratin and acid phosphatase allowed the diagnosis. The authors, at last, evaluate the need of a surgical therapy in Paget's disease of the breast without an underlying adenocarcinoma.- - - - - - - - - - ranking = 1keywords = carcinoma (Clic here for more details about this article) |
2/47. Paget's disease of the male breast associated with intraductal carcinoma.Paget's disease of the breast is a rare condition with an incidence of 3% to 5% of all mammary malignancies. Of all malignant breast cancer, 1% occurs in male patients, and thus, Paget's disease of the male breast is extremely rare. We present a case of intraductal carcinoma of the male breast presenting as Paget's disease.- - - - - - - - - - ranking = 1.6666666666667keywords = carcinoma (Clic here for more details about this article) |
3/47. Erosive adenomatosis of the nipple in an eight-year-old girl.Erosive adenomatosis of the nipple (EAN) is a rare, benign neoplasm of breast lactiferous ducts. Peak incidence is in the fifth decade in women. Clinically, it may be mistaken for Paget's disease and, histologically, for adenocarcinoma. Some authors have proposed an association with breast carcinoma and fibrocystic breast changes. Erosive adenomatosis of the nipple is extremely rare in children. Treatment is usually local excision of the nipple. This is the first formal English language case report of EAN in the pediatric age group. It is important for dermatologists to be familiar with this entity to prevent unwarranted breast removal.- - - - - - - - - - ranking = 0.66666666666667keywords = carcinoma (Clic here for more details about this article) |
4/47. Male Paget's disease of the breast.BACKGROUND: Paget's disease is an extremely rare condition of the male breast that presents as an eczematous change of the nipple and areola. It is almost always associated with an underlying intraductal carcinoma. OBJECTIVE: A case of Paget's disease of the male breast with extension into adnexal structures is reported. MATERIALS AND methods: A medline search for cases of Paget's disease of the male breast was performed and the cases were reviewed. The following antibodies were used in immunohistochemical staining: Rabbit Anti-Human c-erbB-2 Oncoprotein, monoclonal Mouse Anti-Human Estrogen Receptor (IgG1, kappa), and monoclonal Mouse Anti-Human progesterone Receptor (Clone PgR 636). RESULTS: This is only the 43rd histologically proven case of Paget's disease of the male breast in the world literature and, to our knowledge, the first to document extension of Paget's cells into adnexal structures, including eccrine glands. CONCLUSION: Mammary Paget's disease is a rare phenomenon among men.- - - - - - - - - - ranking = 0.33333333333333keywords = carcinoma (Clic here for more details about this article) |
5/47. Pigmented Paget's disease of the male breast: report of a case.An 83-year-old man with pigmented Paget's disease of the breast is reported. He had a blackish swollen right nipple with bloody discharge that lasted for 8 months. Histopathology of the lesion disclosed intraepidermal and dermal atypical cells forming small clusters and underlying intraductal carcinoma. melanocytes were dispersed in the epidermis. Dermal melanophages were also detected. The atypical cells were positive for carcinoembryonic antigen, human-milk fat globule protein and a recently described new antigen, RCAS-1, but negative for S-100 or HMB-45. We diagnosed this case as Paget's disease of the male breast. Paget's disease of the breast is usually nonpigmented and occurs almost exclusively in women. Pigmented Paget's disease of the male breast is extremely rare, and only a few cases have been reported. Albeit rare, pigmented Paget's disease has to be included in the differential diagnosis of pigmented lesions of the nipple.- - - - - - - - - - ranking = 0.33333333333333keywords = carcinoma (Clic here for more details about this article) |
6/47. Bilateral paget disease of the nipple associated with lobular carcinoma in situ.We report synchronous bilateral Paget disease derived from lobular carcinoma in situ in a 53-year-old woman who underwent bilateral mastectomy. The epidermis of both nipples contained small cells with a moderate amount of pale-staining cytoplasm. The nuclei had fine chromatin and identifiable nucleoli. The cells were strongly immunoreactive with cytokeratin 7 and displayed nuclear estrogen receptor reactivity. The underlying mammary gland showed involvement by lobular carcinoma in situ with pagetoid spread into lactiferous ducts, which was confirmed by lack of immunoreactivity for E-cadherin.- - - - - - - - - - ranking = 2keywords = carcinoma (Clic here for more details about this article) |
7/47. Ductal eccrine carcinoma presenting as a Paget's disease-like lesion of the breast.Some types of skin appendage tumors, particularly ductal eccrine carcinomas (DEC), imitate breast carcinomas histologically, thus causing great diagnostic challenges. We describe a case of DEC presenting as an eczematous, crusted skin lesion on the right nipple-areolar complex in a 67-year-old woman. A skin biopsy done under the clinical impression of Paget's disease of the nipple was initially misinterpreted as infiltrating ductal carcinoma, and a subsequent modified radical mastectomy revealed DEC exclusively confined to the nipple with perinodal tumor metastasis in one of the axillary lymph nodes. This case highlights the diagnostic difficulty caused by the histologic homology between breast carcinomas and skin appendage tumors with ductal differentiation.- - - - - - - - - - ranking = 2.6666666666667keywords = carcinoma (Clic here for more details about this article) |
8/47. Pigmented mammary Paget disease and pigmented epidermotropic metastases from breast carcinoma.Pigmented mammary Paget disease is a rare clinicopathologic variant of mammary Paget disease. It has been described in female and male patients with intraductal mammary carcinoma extending to the epidermis of the nipple and areola through a lactiferous duct. Pigmented cutaneous metastases from breast carcinoma are uncommon variants of epidermotropic metastatic breast carcinoma. All these lesions may mimic malignant melanoma clinically and histopathologically. From a histopathologic point of view, involvement of the dermoepidermal junction by neoplastic cells of the mammary carcinoma seems to be a prerequisite for development of the clinical pigmentation. We report three examples of pigmented mammary Paget disease and six cases of pigmented epidermotropic metastases from breast carcinoma, which were studied from both the histopathologic and immunohistochemical points of view. Two cases of pigmented mammary Paget disease and all cases of pigmented epidermotropic metastatic breast carcinoma showed the proliferation of dendritic melanocytes arranged as solitary units along the dermoepidermal junction and intermingled with the neoplastic cells of the mammary carcinoma in the superficial dermis. In one case of pigmented mammary Paget disease, there was abundant melanin within the cytoplasm of the Paget cells, but an increased number of melanocytes could not be demonstrated. Local production of melanocytic chemotactic factor by neoplastic cells of the mammary carcinoma when they reach the dermoepidermal junction has been postulated as the cause of the melanocytic proliferation and clinical hyperpigmentation of these epidermotropic breast carcinomas. Another possibility is the phagocytosis or transfer of melanin from melanocytes to the intraepidermal neoplastic cells of the breast carcinoma. Pigmented mammary Paget disease and pigmented epidermotropic metastatic breast carcinoma should be differentiated from melanoma clinical and histopathologically.- - - - - - - - - - ranking = 5keywords = carcinoma (Clic here for more details about this article) |
9/47. Synchronous bilateral breast cancer with Paget's disease and invasive ductal carcinoma: report of a case.We report a case of synchronous bilateral breast cancer with Paget's disease and invasive ductal carcinoma. A 60-year-old Japanese woman presented with an 8-month history of discharge from the left nipple with eczema and itching. mammography showed grouped fine calcification in the right breast, which was highly suggestive of right breast carcinoma with an intraductal component. ultrasonography did not reveal any mass lesions in the bilateral breasts, and computed tomography and bone scintigraphy showed no site of distant metastasis. We performed a modified radical mastectomy for Paget's disease in the left breast and breast-conserving surgery for ductal carcinoma in the right breast. The histological diagnosis was Paget's disease in the left breast and invasive ductal carcinoma with a predominant intraductal component in the right breast.There was no metastasis in any of the 24 left axillary lymph nodes resected. We also gave her postoperative adjuvant chemoendocrine therapy, comprised of tamoxifen (20 mg) and UFT (uracil/tegafur) (400 mg)daily. The patient has been disease-free for 4 years since her operation.- - - - - - - - - - ranking = 2.6666666666667keywords = carcinoma (Clic here for more details about this article) |
10/47. The place for conservative treatment in the management of Paget's disease of the nipple.Four cases of Paget's disease confined to the nipple are presented. Three of them were treated conservatively by local radiotherapy and the fourth was treated by mastectomy. Histopathological examination of the breast in the last case failed to show any evidence of in situ or invasive carcinoma. The first three patients are well and without evidence of recurrence 3 to 5.5 years after treatment. Could conservative treatment in the form of local excision or radiotherapy offer an alternative to mastectomy? A discussion on the place of conservative treatment is presented.- - - - - - - - - - ranking = 0.33333333333333keywords = carcinoma (Clic here for more details about this article) |
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