Pigmented Paget's disease of the nipple mistaken for melanoma in situ : a diagnostic pitfall for the unwary

Paget’s disease of the breast is a rare type of cancer of the nipple–areola complex and that is often associated with an underlying in situ or invasive carcinoma. It is often misdiagnosed as eczema of breast and treatment is delayed. Here we present a case where a 30 year old female presented with itching ulceration and destruction of her left nipple. She was treated initially by local physicians by applying local ointments but as her condition did not improve she was admitted to department of surgery Shaheed Suhrawardy Medical College hospital where she was diagnosed as Paget’s disease with infiltrating ductal cell carcinoma. She underwent modified radical mastectomy with axillary clearance and referred to oncology department for further management. J Shaheed Suhrawardy Med Coll, June 2019, Vol.11(1); 81-83

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Not All Cases of Mammary Paget’s Disease are Cytokeratin-7 Positive: A Challenging Diagnosis!

International Journal of Surgical Pathology ◽

10.1177/10668969211002920 ◽

2021 ◽

pp. 106689692110029

Author(s):

Kerschen Anja ◽

Dano Hélène ◽

Van Eeckhout Pascal ◽

Marot Liliane ◽

Van Bockstal Mieke

Keyword(s):

Present Report ◽

Paget’S Disease ◽

Growth Factor Receptor ◽

Punch Biopsy ◽

Paget's Disease ◽

Cytokeratin 7 ◽

In Situ Carcinoma ◽

Epidermal Growth ◽

Mammary Paget’S Disease

Mammary Paget’s disease accounts for 1% to 3% of all breast tumors and manifests as a chronic eczematous lesion of the areolar skin. It can occur without any underlying neoplasia or can be present in association with an underlying invasive and/or in situ carcinoma of the breast. The present report describes a challenging nipple punch biopsy showing an infiltration of the lower third to two-thirds of the epidermis by large, ovoid, neoplastic cells. The morphology was consistent with mammary Paget's disease, although immunohistochemistry for cytokeratin-7 (CK7) was repeatedly negative. This resulted in an initial misdiagnosis and, subsequently, a delay in the patient's follow-up. Additional immunohistochemistry for GATA binding protein 3 (GATA3) and human epidermal growth factor receptor 2 (HER2), as well as a second opinion of a breast pathologist, resulted in the diagnosis of mammary Paget's disease. The aim of this article is to raise awareness among pathologists and prevent them from misdiagnosing CK7-negative Paget disease of the breast.

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Expression of programmed cell death ligand 1 (PD‐L1) at in situ and invasive extramammary Paget’s disease and literature review

Australasian Journal of Dermatology ◽

10.1111/ajd.13607 ◽

2021 ◽

Author(s):

Junji Kato ◽

Shintaro Sugita ◽

Kohei Horimoto ◽

Sayuri. Sato ◽

Daisuke Yoneta ◽

...

Keyword(s):

Cell Death ◽

Programmed Cell Death ◽

Literature Review ◽

Paget’S Disease ◽

Paget's Disease ◽

Extramammary Paget’S Disease ◽

Extramammary Paget's Disease

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Ductal Carcinoma in Situ and Paget's Disease

Breast Imaging ◽

10.1016/b978-1-4160-5199-2.00021-7 ◽

2011 ◽

pp. 391-422

Author(s):

Sophia Kim. Apple ◽

Jennifer M.J. Overstreet ◽

Lawrence W. Bassett

Keyword(s):

Ductal Carcinoma In Situ ◽

Carcinoma In Situ ◽

Ductal Carcinoma ◽

Paget’S Disease ◽

Paget's Disease

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Amelanotic Malignant Melanoma of the Male Urethra: A Potential Diagnostic Pitfall

International Journal of Surgical Pathology ◽

10.1177/1066896920919497 ◽

2020 ◽

Vol 28 (5) ◽

pp. 510-513

Author(s):

Alessandro Caputo ◽

Alfonso Califano ◽

Marco Fabiano ◽

Vincenzo Altieri ◽

Pio Zeppa ◽

...

Keyword(s):

Malignant Melanoma ◽

Common Disease ◽

High Grade ◽

Male Urethra ◽

Unusual Site ◽

Diagnostic Pitfall ◽

Melanoma In Situ ◽

Amelanotic Malignant Melanoma ◽

Histological Characteristics

A rare disease in an unusual site can closely mimic a typical presentation of a common disease, sometimes with devastating consequences. We present a case of primary amelanotic malignant melanoma of the urethra in a male, with clinical and histological characteristics that could have led to a mistaken diagnosis of high-grade urothelial carcinoma. Amelanotic mucosal melanoma should be suspected in all cases of high-grade mucosal tumors with practically any appearance (epithelioid, sarcomatoid, anaplastic, mixed). Morphological hints pointing toward melanoma—such as the presence of sparse melanin pigment or melanoma in situ—should be sought, and if absent, an immunohistochemical panel comprising S100 and HMB45 should be performed.

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