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Published on: May 29, 2017
Pagets disease of uncertain origin: case report
Ashok Subramanian1, Hilary Birch, Rita McAvinchey
1Department of General Surgery, East Surrey Hospital, Canada Avenue, Redhill, Surrey, UK. ashsubramanian@hotmail.com
Summary
Paget's disease of the nipple, often linked to breast cancer, can recur even after treatment. This case highlights a rare instance of Paget's disease appearing without apparent underlying breast tissue.
Area of Science:
- Oncology
- Dermatology
- Surgical Pathology
Background:
- Paget's disease of the nipple is an eczematous lesion associated with underlying breast malignancy in 1-4% of breast cancer cases.
- The majority of cases involve invasive disease, with 40-45% linked to Ductal Carcinoma in Situ (DCIS).
Purpose of the Study:
- To report a unique case of Paget's disease of the nipple with an uncertain origin.
- To discuss the diagnostic and management challenges presented by this rare condition.
Main Methods:
- A 39-year-old female presented with a palpable breast lump.
- Investigations revealed extensive high-grade DCIS with foci of invasive carcinoma, treated with mastectomy and reconstruction.
- Recurrence as Paget's disease was noted adjacent to the scar one year post-surgery.
Main Results:
- Histological examination confirmed high-grade DCIS with invasive components.
- Post-reconstruction, the patient developed a nodule consistent with Paget's disease.
- Excision confirmed Paget's disease, with no identifiable underlying breast or apocrine tissue.
Conclusions:
- This case presents Paget's disease of uncertain origin, challenging conventional understanding.
- The findings underscore the importance of vigilant follow-up for breast cancer patients.
- Further research into extramammary Paget's disease and its origins is warranted.
