A Rare Case Of Pigmented Mammary Paget Disease

Pigmented mammary Paget disease is a rare clinicopathologic variant of mammary Paget disease, which can mimic melanoma. We report a patient who visited the dermatology department complaining of asymptomatic brown-black plaque localized on the left nipple that had been present for 1 year. Histopathology showed large neoplastic epithelial cells with enlarged nuclei and pale cytoplasm, some harboring granular brown melanin pigment. Immunohistochemical studies showed that the intraepidermal pagetoid cells were positive for CK7, ER, and Her2, while mostly lacking immunoreactivity for CK5, SOX10, and HMB45, supporting a diagnosis of MPD. Therefore, physicians should be aware of this rare entity when diagnosing patients with pigmented lesions on the breast area.