Korean J Dermatol.  2010 Oct;48(10):856-861.

Pigmented Paget's Disease: A Rare Clinical Manifestation of Recurred Breast Carcinoma

Affiliations
  • 1Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea. sjyun@chonnam.ac.kr
  • 2Department of General Surgery, Chonnam National University Medical School, Gwangju, Korea.

Abstract

Pigmented mammary Paget's disease is a rare variant of mammary Paget's disease, and this mimics malignant melanoma both clinically and histopathologically. Two women aged 48 and 44 years old, respectively, presented with 2-cm pigmented patches and 1-cm pigmented erosive crusted papules without discharge or palpable masses, respectively. They had previously undergone breast-conserving surgery following the diagnosis of intraductal carcinoma of the breast. Physical examinations and imaging studies revealed no evidence of the recurrence of breast cancer. However, histopathological and immunohistochemical analyses demonstrated the presence of 1) Paget's cells in the epidermis and these cells contained melanin within their cytoplasm and 2) numerous melanophages in the upper dermis. We diagnosed the two patients with pigmented Paget's disease. Subsequent pathological analyses revealed recurrent intraductal carcinoma. We recommend that skin biopsies should be taken from patients presenting with pigmented lesions of the nipple, who have previously undergone breast-conserving treatment, to test the possibility of cancer recurrence.

Keyword

Areola; Melanoma; Nipple; Pigmented mammary Paget's disease; Recurrent breast carcinoma

MeSH Terms

Aged
Biopsy
Breast
Breast Neoplasms
Carcinoma, Intraductal, Noninfiltrating
Cytoplasm
Dermis
Epidermis
Female
Humans
Mastectomy, Segmental
Melanins
Melanoma
Nipples
Paget's Disease, Mammary
Physical Examination
Recurrence
Skin
Melanins
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