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 - Funding Information:
The authors would like to acknowledge Ms. Hang Nguyen for her help in preparation of the tables for this article. The author(s) received no financial support for the research, authorship, and/or publication of this article.
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 -