Unilateral Mammary Paget Disease Associated with Underlying Synchronous Breast Tumors: Report of A Case

Paget disease of the breast was described as nipple ulceration associated with underlying breast cancer. A 67-year-old female patient was referred to dermatology outpatient clinic for evaluation of a scaly erythematous 2 cm plaque in the left nipple and nearby areola. The patient was suspected to have Paget disease. A retroareolar mass approximately 1 cm in size was found on breast examination performed by a general surgeon. Mammograms demonstrated two masses in the left breast. In the histopathological examination of mastectomy specimen two nodules were detected in the inferolateral breast quadrant compatible with Grade II invasive ductal carcinoma. High grade ductal carcinoma in situ and Paget disease were detected in the nipple-areola complex. All of the lesions showed similar immunohistochemistry profiles on immunohistochemical examination. The absence of E-cadherin staining in our patient’s Paget cells implies that E-cadherin mutation may play a role in the development of Paget disease.