TY - JOUR
T1 - Mammary Paget’s Disease of the Male Breast
T2 - A Rare Case With an Unusual Immunohistochemical Profile
AU - Moore, Samantha A.
AU - Notgrass, Hollis M.
AU - Vandergriff, Travis W.
AU - Sahoo, Sunati
N1 - Publisher Copyright:
© The Author(s) 2019.
PY - 2020/4/1
Y1 - 2020/4/1
N2 - Mammary Paget’s disease is rare and comprises about 0.62% of all breast cancer cases, only 1.65% of which occur in male patients. This case report involves a 76-year-old man who presented to his primary care physician with an itching, scaly, unilateral lesion involving the nipple skin. He underwent wide local excision of the lesion for a diagnosis of Bowen’s disease (squamous cell carcinoma in situ). Histologic examination of the specimen revealed mammary Paget’s disease with ductal carcinoma in situ in the underlying breast tissue. A panel of immunohistochemical stains revealed the Paget cells to be positive for cytokeratin 7, MUC1, GATA3, and androgen receptor and negative for cytokeratins 5/6, p63, SOX10, and MART-1/Melan-A. Paget cells were also negative for estrogen receptor and progesterone receptor, and positive for HER2/neu. However, the underlying ductal carcinoma in situ was positive for both estrogen receptor and progesterone receptor and negative for HER2/neu. This discordance, supported by the current literature, suggests an alternative etiology for Paget’s disease in certain cases that cannot be explained by the well-established epidermotropic and transformative theories of Paget’s disease evolution.
AB - Mammary Paget’s disease is rare and comprises about 0.62% of all breast cancer cases, only 1.65% of which occur in male patients. This case report involves a 76-year-old man who presented to his primary care physician with an itching, scaly, unilateral lesion involving the nipple skin. He underwent wide local excision of the lesion for a diagnosis of Bowen’s disease (squamous cell carcinoma in situ). Histologic examination of the specimen revealed mammary Paget’s disease with ductal carcinoma in situ in the underlying breast tissue. A panel of immunohistochemical stains revealed the Paget cells to be positive for cytokeratin 7, MUC1, GATA3, and androgen receptor and negative for cytokeratins 5/6, p63, SOX10, and MART-1/Melan-A. Paget cells were also negative for estrogen receptor and progesterone receptor, and positive for HER2/neu. However, the underlying ductal carcinoma in situ was positive for both estrogen receptor and progesterone receptor and negative for HER2/neu. This discordance, supported by the current literature, suggests an alternative etiology for Paget’s disease in certain cases that cannot be explained by the well-established epidermotropic and transformative theories of Paget’s disease evolution.
KW - breast cancer
KW - ductal carcinoma in situ
KW - immunohistochemistry
KW - male breast
KW - mammary Paget’s disease
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U2 - 10.1177/1066896919874878
DO - 10.1177/1066896919874878
M3 - Article
C2 - 31514589
AN - SCOPUS:85073986544
SN - 1066-8969
VL - 28
SP - 210
EP - 215
JO - International Journal of Surgical Pathology
JF - International Journal of Surgical Pathology
IS - 2
ER -