A Paget's disease Case of Breast without Underlying Carcinoma

Abstract

Paget's disease of the breast is a rare type of cancer of the nipple-areola complex which is characterized by eczematous lesions. It is often associated with an underlying in-situ or invasive carcinoma but it is not a must. Paget's disease might be misdiagnosed as nipple eczema and this may cause a delay in the diagnosis. A 65-year old female patient admitted to our department with a 1-year history of erythema and swelling which started over the left nipple and spread to the areola. The patient used topical steroid treatment which was unsuccessful. In her medical history, there was total right mastectomy operation for diagnosed ductal carcinoma. The patient presented with no active palpable mass at left breast or lymph nodes on both sides at that moment. Dermatological examination revealed sharp bordered, erythematous, mildly squamated, 2x3 cm in diameter, solitary plaque lesion located on left nipple. Radiological imaging showed no abnormalities. Histopathological examination and immunohistochemical staining were compatible with Paget's disease. Surgery was scheduled. This case has been presented to lay emphasis on Paget's disease which may be misdiagnosed easily and to remind that it could be without concurrent underlying malignancy at all.