Mammary Paget's disease occurring after mastectomy
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Case report
Mammary Paget's disease occurring after mastectomy Monica Giovannini*1, Carmelo D'Atri2, Quirino Piubello3 and Annamaria Molino4 Address: 1Department of Medical Oncology, San Raffaele Scientific Institute, Milan, Italy, 2Department of Surgery, Civic Hospital, Verona, Italy, 3Department of Pathology, Civic Hospital, Verona, Italy and 4Department of Medical Oncology, University of Verona, Italy Email: Monica Giovannini* - [email protected]; Carmelo D'Atri - [email protected]; Quirino Piubello - [email protected]; Annamaria Molino - [email protected] * Corresponding author
Published: 09 August 2006 World Journal of Surgical Oncology 2006, 4:51
doi:10.1186/1477-7819-4-51
Received: 20 April 2006 Accepted: 09 August 2006
This article is available from: http://www.wjso.com/content/4/1/51 © 2006 Giovannini et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract Background: Mammary Paget's disease and extramammary Paget's disease are neoplastic conditions, in which there is intraepithelial (usually intraepidermal) infiltration by neoplastic cells showing glandular differentiation. Mammary Paget's disease occurs exclusively on the nipple/areola complex from where it may spread to the surrounding skin. Case presentation: We here describe a case of Paget's disease occurring on the thoracic wall site of a previous simple mastectomy, and also briefly summarise the most important aspects leading to a diagnosis of mammary Paget's disease. Conclusion: To the best of our knowledge, this is the first reported case of mammary Paget's disease occurring after mastectomy. The absence of the nipple/areola complex obviously raised some questions concerning whether it was mammary or extra-mammary Paget's disease, and how it could occur in the absence of the nipple/areola complex.
Background Mammary Paget's disease occurs exclusively on the nipple/areola complex from where it may spread on to surrounding skin. Extramammary Paget's disease occurs most commonly in the anogenital region but can arise in any area of skin and mucosa. Mammary Paget's disease accounts for 2–3% of neoplastic conditions of the breast and in most cases (82–92% in several studies) tumour cells have spread to the skin of the nipple and areola from underlying invasive carcinoma or ductal carcinoma in situ [1-3]. The neoplasm associated with mammary Paget's disease, which may or may not be palpable, is usually centrally located (within 2 cm of the areola) but occasionally may be more peripherally sited
[1,2]. In cases where a mass is palpable, invasive carcinoma is likely to be found. Conversely, cases of mammary Paget's disease with no palpable mass are more likely to have ductal carcinoma in situ only (66% of cases in one study) [2]. Mammary Paget's
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