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Advanced lesions of synchronous bilateral mammary Paget’s disease: a case report
BACKGROUND: Mammary Paget’s disease is an eczematous eruption on the nipple and areola with underlying breast malignancy. It is often misinterpreted as chronic dermatitis or psoriasis causing a delayed diagnosis. Synchronous bilateral mammary Paget’s disease is exceptionally rare and an advanced cas...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BioMed Central
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7401214/ https://www.ncbi.nlm.nih.gov/pubmed/32753069 http://dx.doi.org/10.1186/s13256-020-02442-5 |
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author | Choridah, Lina Sari, Wida Kartika Dwianingsih, Ery Kus Widodo, Irianiwati Suwardjo Anwar, Sumadi Lukman |
author_facet | Choridah, Lina Sari, Wida Kartika Dwianingsih, Ery Kus Widodo, Irianiwati Suwardjo Anwar, Sumadi Lukman |
author_sort | Choridah, Lina |
collection | PubMed |
description | BACKGROUND: Mammary Paget’s disease is an eczematous eruption on the nipple and areola with underlying breast malignancy. It is often misinterpreted as chronic dermatitis or psoriasis causing a delayed diagnosis. Synchronous bilateral mammary Paget’s disease is exceptionally rare and an advanced case with underlying invasive carcinoma might require long-term treatment and follow-up that could affect a patient’s physical, psychological, and social aspects of well-being. CASE PRESENTATION: A 54-year-old Javanese woman presented in our clinic with a 2-year history of itching and chronic eczema in both areolae. Bilateral nipple retraction and retro-areolar palpable lumps were observed during the first presentation. Breast ultrasound revealed hypoechoic lesions in her left and right breasts. Mammograms showed an irregular hyperdense lesion and multiple microcalcifications. Histopathology from biopsy and bilateral mastectomy demonstrated infiltration of large Paget’s cells in the epidermis of the areola with underlying lesions of invasive ductal carcinoma, diagnosed solid type with high nuclear grade and negative expression of estrogen receptor and progesterone receptor, with positive expression of human epidermal growth receptor-2(HER2) and Ki-67 (45%). CONCLUSIONS: In a patient with suspicious chronic inflammation of the nipple and areolae, prompt biopsy should be performed to avoid a delayed diagnosis of any malignant breast lesion. |
format | Online Article Text |
id | pubmed-7401214 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-74012142020-08-06 Advanced lesions of synchronous bilateral mammary Paget’s disease: a case report Choridah, Lina Sari, Wida Kartika Dwianingsih, Ery Kus Widodo, Irianiwati Suwardjo Anwar, Sumadi Lukman J Med Case Rep Case Report BACKGROUND: Mammary Paget’s disease is an eczematous eruption on the nipple and areola with underlying breast malignancy. It is often misinterpreted as chronic dermatitis or psoriasis causing a delayed diagnosis. Synchronous bilateral mammary Paget’s disease is exceptionally rare and an advanced case with underlying invasive carcinoma might require long-term treatment and follow-up that could affect a patient’s physical, psychological, and social aspects of well-being. CASE PRESENTATION: A 54-year-old Javanese woman presented in our clinic with a 2-year history of itching and chronic eczema in both areolae. Bilateral nipple retraction and retro-areolar palpable lumps were observed during the first presentation. Breast ultrasound revealed hypoechoic lesions in her left and right breasts. Mammograms showed an irregular hyperdense lesion and multiple microcalcifications. Histopathology from biopsy and bilateral mastectomy demonstrated infiltration of large Paget’s cells in the epidermis of the areola with underlying lesions of invasive ductal carcinoma, diagnosed solid type with high nuclear grade and negative expression of estrogen receptor and progesterone receptor, with positive expression of human epidermal growth receptor-2(HER2) and Ki-67 (45%). CONCLUSIONS: In a patient with suspicious chronic inflammation of the nipple and areolae, prompt biopsy should be performed to avoid a delayed diagnosis of any malignant breast lesion. BioMed Central 2020-08-04 /pmc/articles/PMC7401214/ /pubmed/32753069 http://dx.doi.org/10.1186/s13256-020-02442-5 Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Case Report Choridah, Lina Sari, Wida Kartika Dwianingsih, Ery Kus Widodo, Irianiwati Suwardjo Anwar, Sumadi Lukman Advanced lesions of synchronous bilateral mammary Paget’s disease: a case report |
title | Advanced lesions of synchronous bilateral mammary Paget’s disease: a case report |
title_full | Advanced lesions of synchronous bilateral mammary Paget’s disease: a case report |
title_fullStr | Advanced lesions of synchronous bilateral mammary Paget’s disease: a case report |
title_full_unstemmed | Advanced lesions of synchronous bilateral mammary Paget’s disease: a case report |
title_short | Advanced lesions of synchronous bilateral mammary Paget’s disease: a case report |
title_sort | advanced lesions of synchronous bilateral mammary paget’s disease: a case report |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7401214/ https://www.ncbi.nlm.nih.gov/pubmed/32753069 http://dx.doi.org/10.1186/s13256-020-02442-5 |
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