Solid papillary carcinoma of the breast with an associated Cytokeratin 7- negative Paget's disease of the nipple. Report of a first case

Rupp, Niels J.; Rodewald, A.-K.; Chiesa, Federica; Varga, Zsuzsanna

doi:10.1111/tbj.12971

Cited by 4 publications

(2 citation statements)

References 12 publications

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“…10,11 Some authors suggest performing additional HER2 immunohistochemistry, although HER2 can be negative in ∼10% of MPD cases, as illustrated by the current case. Therefore, we emphasize the importance of GATA3 immunohistochemistry, in accordance with Ozerdem et al 11 and Rupp et al 12 immunohistochemistry for ER and PR can be useful as well, as illustrated by the current case, but (dermato-)pathologists should be aware that MPD can be ER and PR negative. 13,14…”

Section: Discussionsupporting

confidence: 82%

Not All Cases of Mammary Paget’s Disease are Cytokeratin-7 Positive: A Challenging Diagnosis!

2021

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Mammary Paget’s disease accounts for 1% to 3% of all breast tumors and manifests as a chronic eczematous lesion of the areolar skin. It can occur without any underlying neoplasia or can be present in association with an underlying invasive and/or in situ carcinoma of the breast. The present report describes a challenging nipple punch biopsy showing an infiltration of the lower third to two-thirds of the epidermis by large, ovoid, neoplastic cells. The morphology was consistent with mammary Paget's disease, although immunohistochemistry for cytokeratin-7 (CK7) was repeatedly negative. This resulted in an initial misdiagnosis and, subsequently, a delay in the patient's follow-up. Additional immunohistochemistry for GATA binding protein 3 (GATA3) and human epidermal growth factor receptor 2 (HER2), as well as a second opinion of a breast pathologist, resulted in the diagnosis of mammary Paget's disease. The aim of this article is to raise awareness among pathologists and prevent them from misdiagnosing CK7-negative Paget disease of the breast.

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Section: Discussionsupporting

confidence: 82%

Not All Cases of Mammary Paget’s Disease are Cytokeratin-7 Positive: A Challenging Diagnosis!

2021

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“…Nur vereinzelt sind auch CK7negative Fälle beschrieben, z. B. in Zusammenhang mit einem solid-papillären Karzinom [46] oder isolierten M. Paget [41]. Die Angaben über die Häufigkeit der Expression des Östrogenrezep-…”

Section: Histologie Und Immunhistologieunclassified

Pathologie der Mamillenregion

Streng

Gutjahr

Aulmann³

et al. 2020

Pathologe

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ZusammenfassungDer klassische M. Paget der Mamille ist histologisch charakterisiert durch eine intraepidermale Tumorinfiltration, die von einem intraduktalen oder invasiven Mammakarzinom ausgeht, immunhistologisch durch eine regelhafte Überexpression von HER2 und klinisch durch ekzemartige Veränderungen von Mamille und Areola. Zu den Varianten mit davon abweichenden histologischen, immunhistologischen und klinischen Erscheinungsformen gehören der isolierte M. Paget der Mamille, der anaplastische M. Paget, der M. Paget mit Invasion und der pigmentierte M. Paget der Mamille. Differenzialdiagnostisch ist der M. Paget der Mamille abzugrenzen gegenüber benignen Veränderungen, insbesondere der Toker-Zell-Hyperplasie, dem Mamillenekzem und seltenen Dermatosen.

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Male Mammary Paget Disease: A Tale of 2 Contrasting Cases

Roy¹,

Teshome²,

Damodaran

et al. 2020

The American Journal of Dermatopathology

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Mammary Paget disease (MPD) comprises 1.45% all male breast cancers, compared with only 0.68% of all female breast cancers. Patients usually present in the fifth and sixth decades of life with ulceration, eczematous changes, discharge, bleeding, itching, and induration of the nipple and areola. Typically, there is a delay in definitive diagnosis and treatment from the onset of symptoms because most patients are initially treated for a rash. At the time of diagnosis, about half of the patients may have palpable breast mass, positive lymph nodes, or both. In this article, we present 2 cases of male MPD representing the extremes of clinical, radiologic, and histopathologic spectrum of the disease. One patient presented with a rash of the nipple of several months duration without an underlying lesion, whereas the other presented with sensitivity and pain of the nipple for 1 year and an underlying mass. Biopsies were diagnostic of MPD in both cases, and definitive surgery revealed an underlying ductal carcinoma in situ in the first case and an invasive ductal carcinoma in the second, highlighting the importance of early biopsy to initiate appropriate management.

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Solid papillary carcinoma of the breast with an associated Cytokeratin 7- negative Paget's disease of the nipple. Report of a first case

Cited by 4 publications

References 12 publications

Not All Cases of Mammary Paget’s Disease are Cytokeratin-7 Positive: A Challenging Diagnosis!

Not All Cases of Mammary Paget’s Disease are Cytokeratin-7 Positive: A Challenging Diagnosis!

Pathologie der Mamillenregion

Male Mammary Paget Disease: A Tale of 2 Contrasting Cases

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