Intraepidermal malignancy in breast skin: A tale of two tumours

Zhao, Zitong; Tay, Timothy Kwang Yong; Agrawal, Rajesh; Tan, Veronique Kiak Mien; Tan, Yah Yuen; Tan, Puay Hoon

doi:10.1016/j.ehpc.2018.07.001

Cited by 5 publications

(16 citation statements)

References 19 publications

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“…In Paget disease, clear cells (Paget cells) are observed, and glandular formation can be present. 1,3,5 Previous literature has described that pagetoid cells are present in superficial layers in pagetoid Bowen disease, whereas they 4 In concordance, pagetoid cells can be observed close to the stratum corneum in both of our cases (Figures 2A,B and 4B).…”

Section: Discussionsupporting

confidence: 86%

“…2 It shows pagetoid cells in the epidermis, with a large, pale cytoplasm, that lack the immunohistochemical characteristics of Paget disease. [4][5][6] It is crucial to perform a correct differential diagnosis between pagetoid Bowen disease and Paget disease, especially when it is located on the breast, because therapeutic approach and prognosis is very different for each of them. [1][2][3] Bowen disease is an intraepidermal carcinoma, which only rarely progresses to invasive squamous cell carcinoma, and which is not linked to an underlying breast F I G U R E 1 Clinical features.…”

Section: Discussionmentioning

confidence: 99%

“…Clinically, Paget disease is characterized by eczematoid changes of the nipple. 5 Bowen disease appears as an erythematous, ulcerated lesion. Because no cases of pagetoid Bowen disease of the nipple had been reported until now, previous literature has suggested that the existence of clinical nipple involvement can be a clue that points toward Paget disease.…”

Section: Discussionmentioning

confidence: 99%

“…Conventional histopathological analysis of hematoxylin and eosin-stained sections can sometimes help to distinguish pagetoid Bowen disease from Paget disease. 5 However, in almost every case immunohistochemical stains are essential. 2,3,6 Morphologically, it has been stated that Bowen disease shows epidermal hyperplasia.…”

Section: Discussionmentioning

confidence: 99%

“…1 On the contrary, CK34betaE12 and p63 are positive in pagetoid Bowen disease, and negative in Paget disease. 1,2,5,17 However, these last two stains can also be positive in the background benign epidermal cells. 5 In our cases, as observed in previous studies, 5,9,18 tumoral cells were positive for both CK34betaE12 and p63, but positivity was weaker on the tumoral cells than in the adjacent benign cells.…”

Section: Discussionmentioning

confidence: 99%

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Differentiating pagetoid Bowen disease from Paget disease on the nipple‐areola complex: Two unique, challenging cases

et al. 2021

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Pagetoid Bowen disease is a subtype of Bowen disease that accounts for 5% of Bowen disease. It is extremely rare for Bowen disease to appear on the nipple-areola complex, with only seven cases described in the previous literature. Of those seven cases, only one was of the pagetoid subtype. We report two cases of pagetoid Bowen disease on this location, one of them being the first case of pagetoid Bowen disease affecting the nipple reported to date. On this location, it is crucial to perform a meticulous differential diagnosis to rule out Paget disease, because of its contrasting therapeutic and prognostic implications. In order to do this, clinical and histopathological aspects must be considered. From a clinical point of view, previous literature has stated that nipple involvement can be a clue that points to Paget disease. However, one of our cases shows that this is not always true. Regarding histopathological analysis, a complete excision of the tumor might be necessary to observe clear features of Bowen disease, such as full-thickness atypia of the epidermis and intercellular bridges. An immunohistochemical panel comprising carcinoembryonic antigen, gross cystic disease fluid protein, epithelial membrane antigen, p63, CK34betaE12, periodic acid-Schiff, estrogen receptor, and progesterone receptor can be decisive in complicated cases.

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Section: Discussionsupporting

confidence: 86%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Differentiating pagetoid Bowen disease from Paget disease on the nipple‐areola complex: Two unique, challenging cases

et al. 2021

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Nipple Lesions of the Breast

Brogi,

Scatena

2023

Advances in Anatomic Pathology

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Because of the unique anatomic structure of the nipple, a few specific breast lesions occur only at this site. Large lactiferous sinuses may be involved by inflammatory conditions such as squamous metaplasia of lactiferous ducts and ductal ectasia or be the site of uncommon superficial epithelial neoplasms such as nipple adenoma or syringomatous tumor of the nipple. Paget disease of the nipple may be secondary to intraepidermal extension of ductal carcinoma in situ in the underlying lactiferous ducts or develop from malignant transformation of Toker cells. Invasive breast cancer may also arise primarily in the nipple. Most of these conditions present as a palpable mass and/or skin changes with or without nipple discharge. Due to the delicate location and often relatively small size of nipple lesions, biopsy specimens are often superficial and fragmented, and the interpretation is challenging. Knowledge of the morphologic and immunophenotypic features of nipple lesions is essential in making the correct diagnosis. Information on the molecular alterations underpinning nipple neoplasms is currently very limited.

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Mammary Paget’s Disease: An Update

Markarian

Holmes

2022

Cancers

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Mammary Paget’s Disease is a non-invasive cutaneous malignancy of the breast involving the nipple-areolar complex that is commonly mistaken for benign breast conditions, leading to delay in diagnosis. This review article discusses Paget’s disease etiology, clinical presentation, differential diagnosis, diagnostic work-up, natural history and prognosis. This article also discusses evolving strategies for the surgical and non-surgical management of Paget’s disease.

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Intraepidermal malignancy in breast skin: A tale of two tumours

Cited by 5 publications

References 19 publications

Differentiating pagetoid Bowen disease from Paget disease on the nipple‐areola complex: Two unique, challenging cases

Differentiating pagetoid Bowen disease from Paget disease on the nipple‐areola complex: Two unique, challenging cases

Nipple Lesions of the Breast

Mammary Paget’s Disease: An Update

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