Related Experiment Video
Updated: May 27, 2026
A 3D Organotypic Melanoma Spheroid Skin Model
Published on: May 18, 2018
Pigmented mammary Paget's disease mimicking melanoma: report of three cases
Tokimasa Hida1, Akihiro Yoneta, Takahiro Nishizaka
1Department of Dermatology, Sapporo Medical University, South 1 West 16 Chuo-ku, Sapporo 060-8543, Japan. hidat@sapmed.ac.jp
Abstract:
Pigmented mammary Paget's disease (PMPD) is a rare subtype of mammary Paget's disease. The differential diagnosis of PMPD and melanoma is difficult clinically and sometimes histopathologically. Here we present three cases of PMPD with a variable-sized lesion. All cases showed an irregular-shaped black-brown macule, one of which was accompanied by nipple retraction. Dermoscopically, all cases showed reticular pigmentation with or without irregular black dots, regression structures and streaks, which were indistinguishable from those of melanoma. In all but one of the cases, preoperative examinations confirmed the presence of a subcutaneous mammary lesion. All patients underwent a total mastectomy with the histopathological results indicating invasive ductal carcinoma. These cases emphasize how difficult it is to distinguish PMPD from melanoma. Dermoscopic features also mimic those of melanoma, but the reticular pigmentation seen in all cases could be a feature specific to PMPD. For suspicious cases, histopathological assessment using immunohistochemistry is highly recommended.
Insights
Pigmented mammary Paget's disease (PMPD) can mimic melanoma, posing diagnostic challenges. Reticular pigmentation on dermoscopy may aid in distinguishing PMPD from melanoma, but histopathology is crucial for definitive diagnosis.
Area of Science:
- Oncology
- Dermatology
- Pathology
Background:
- Pigmented mammary Paget's disease (PMPD) is a rare condition.
- Distinguishing PMPD from melanoma is clinically and histopathologically challenging.
Observation:
- Three cases of PMPD presented with irregular, black-brown macules, sometimes with nipple retraction.
- Dermoscopy revealed reticular pigmentation, black dots, regression structures, and streaks, mimicking melanoma.
- Subcutaneous mammary lesions were detected preoperatively in most cases.
Findings:
- Dermoscopic features of PMPD were indistinguishable from melanoma.
- Reticular pigmentation was a consistent finding in PMPD cases.
- All patients were diagnosed with invasive ductal carcinoma post-mastectomy.
Implications:
- These cases highlight the diagnostic difficulty between PMPD and melanoma.
- Reticular pigmentation may be a specific dermoscopic feature of PMPD.
- Histopathological assessment with immunohistochemistry is essential for accurate diagnosis of suspicious lesions.
