We report herein an extremely rare case of primary scirrhous carcinoma of the nipple, being of particular interest in that the patient presented with symptoms very similar to those of Paget's disease. The carcinoma cells were detected by aspiration biopsy cytology rather than by touch smear, although both were performed to differentiate this lesion from Paget's disease and other diseases of the nipple. Thus, we recommend that both touch smear and aspiration biopsy cytology should be performed for all patients presenting with symptoms such as those observed in this case to rule out the possibility of scirrhous carcinoma of the nipple or Paget's disease.