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MEMENİN PAGET HASTALIĞI: OLGU SUNUMU

Year 2012, Volume: 13 Issue: 2, 39 - 42, 01.08.2012

Abstract

Yirmi sekiz yaşında kadın hasta, sağ meme başında iki yıldır bulunan topikal tedaviye yanıtsız, kaşıntılı lezyon nedeniyle başvurduğu üniversitemiz dermatoloji polikliniğinde yapılan muayene ve biyopsi sonucunda memenin paget hastalığı tanısı konulması üzerine cerrahi tedavi amacıyla genel cerrahi polikliniğine yönlendirilmişti. Hastanın yapılan meme muayenesinde sağ meme başı ve areolada lokalize keskin sınırlı, eritemli üzerinde sarımsı krut ve seröz akıntı bulunan bir lezyon mevcuttu. Yapılan bilateral meme ve aksilla muayenesinde patoloji saptanmadı. Mamografide sağ meme üst dış kadranda kuşkulu malign özellikler taşıyan pleomorfik mikrokalsifikasyon odağı saptanması üzerine yapılan vakum destekli biyopsi sonucunda intraduktal karsinom gelmesi üzerine hastaya cilt koruyucu mastektomi ve Becker protez ile eş zamanlı meme rekonstrüksiyonu uygulandı. Bu olgu bazında ilgili literatür gözden geçirilerek 30 yaş altı Paget hastalığı tartışılmıştır

References

  • 1. Caliskan M, Gatti G, Sosnovskikh İ, Rotmensz N, Botteri E, Musmeci S, et al. Paget's disease of the breast: the experience of the European Institute of oncology and review of the literature. Breast CancerRes Treat 2008;112:513-21.
  • 2. Sakorafas GH, Blanchard K, Sarr MG, Farley DR Paget's disease of the breast. Cancer Treat Rev 2001;27:9-18.
  • 3. Neuhaus IM, Grekin RC. Mammary and extramammary Paget disease. In: Wolff K, Goldsmith LA, Katz SI, Gilchrest BA, Pallere AS, Leffell DJ, editors. Fitzpatrick's dermatology in general medicine, 7th ed. McGrawHill Medical, New York, 2008: 1094-9.
  • 4. Albrektsen G, Heuch I, Thoresen S. Histological type and grade of breast cancer tumors by parity, age at birth nd time since birth: a register-based study in Norway. BMC Cancer 2010;10:226
  • 5. Rütten A. Adnexal tumors. In: Burgdorf WHC, Plewig G, Wolff HH, Landthaler M, editors. Braun-Falco's Dermatology, 3rd ed. Springer Medizin Verlag, Italy, 2009;1377-96
  • 6. Wood WS, Hegedus C. Mammary Paget's Disease and Intraductal Carcinoma. Am J Dermatopathol 1988;10:183-88.
  • 7. Cohen C, Guarner J, DeRose PB. Mammary Paget's d is e a s e a n d a ss o c i a t e d c a r c i n oma . A n immunohistochemical study. Arch Pathol Lab Med 1993;117:291-94.
  • 8. Kothari AS, Beechey-Newman N, Hamed H, Fentiman IS, D'Arrigo C, Hanby AM. Paget disease of the nipple. A multifocal manifestation of higher-risk disease. Cancer 2002;95:1-7.
  • 9. Chen CY, Sun LM, Anderson BO. Paget disease of the breast: Changing patterns of incidence, clinical presentation, and treatment in the U.S. Cancer 2006;107:1448-58.
  • 10. Vielh P, Validire P, Kheirallah S, Campana F, Fourquet A, Di Bonito L. Paget's disease of the nipple without clinically and radiologically detectable breast tumor. Histochemical and immunohistochemical study of 44 cases. Pathol Res Pract 1993;189:150-5.
  • 11. Sahoo S, Green I, Rosen PP. Bilateral Paget disease of the nipple associated with lobular carcinoma in situ. Arch Pathol Lab Med 2002;126:90-2.
  • 12. Olson JA Jr, Morris EA, Van Zee KJ, Linehan DC, Borgen PI. Magnetic resonance imaging facilitates breast conservation for occult breast cancer. Ann Surg Oncol 2000;7:411-5.
  • 13. Amano G, Yajima M, Moroboshi Y, Kuriya Y, Ohuchi N. MRI accurately depicts underlying DCIS in a patient with Paget's disease of the breast without palpable mass and mammography findings. Jpn J Clin Oncol 2005;35:149-53.
  • 14. Eusebio RB, Deckers PJ. Paget's disease of the nipple￾areola complex: A plea for conservatism. Contemp Surg 1992;40:13-6.
  • 15. Sheen-Chen SM, Chen HS, Chen WJ, Eng HL, Sheen CW, Chou FF. Paget disease of the breast-an easily overlooked disease. J Surg Oncol 2001;76:261-5.
  • 16. Kayar R, Çatal H. Memenin paget hastalığında cerrahi: Ülkemizdeki yaklaşım: Actuel Medicine 2010;18:25- 30.
  • 17. Yim JH, Wick MR, Philpott GW, Norton JA, Doherty GM. Underlying pathology in mammary Paget's disease. Ann Surg Oncol 1997;4:287-92

Paget's Disease of the Breast: A Case Report

Year 2012, Volume: 13 Issue: 2, 39 - 42, 01.08.2012

Abstract

Our case is a twenty-eight-year-old female lady who admitted to dermatology clinic of our university hospital with itchy lesions on her nipple-areolar complex of her right breast. She had these symptoms and signs for nearly two years and these lesions did not respond to topical treatment. Punch biopsy of the lesion revealed Paget's disease of the breast and the patient was referred to general surgery department. A sharply demarcated erythematous lesion with yellowish crusts were found at the nipple-areolar complex of right breast. No lumps were palpated in both of the breast and axillary examination was normal bilaterally. Mammography of right breast revealed pleomorphic microcalcifications with suspicious features of malignancy in the upper outside quadrant of the breast. Vacuum-assisted biopsy was performed and histopathological examination revealed İntraductal carcinoma. Skin sparing mastectomy and an immediate breast reconstruction with a Becker prosthesis was performed. The incidence of Paget disease below the age of thirty and the clinicopathological features of the disease were discussed in this case report.

References

  • 1. Caliskan M, Gatti G, Sosnovskikh İ, Rotmensz N, Botteri E, Musmeci S, et al. Paget's disease of the breast: the experience of the European Institute of oncology and review of the literature. Breast CancerRes Treat 2008;112:513-21.
  • 2. Sakorafas GH, Blanchard K, Sarr MG, Farley DR Paget's disease of the breast. Cancer Treat Rev 2001;27:9-18.
  • 3. Neuhaus IM, Grekin RC. Mammary and extramammary Paget disease. In: Wolff K, Goldsmith LA, Katz SI, Gilchrest BA, Pallere AS, Leffell DJ, editors. Fitzpatrick's dermatology in general medicine, 7th ed. McGrawHill Medical, New York, 2008: 1094-9.
  • 4. Albrektsen G, Heuch I, Thoresen S. Histological type and grade of breast cancer tumors by parity, age at birth nd time since birth: a register-based study in Norway. BMC Cancer 2010;10:226
  • 5. Rütten A. Adnexal tumors. In: Burgdorf WHC, Plewig G, Wolff HH, Landthaler M, editors. Braun-Falco's Dermatology, 3rd ed. Springer Medizin Verlag, Italy, 2009;1377-96
  • 6. Wood WS, Hegedus C. Mammary Paget's Disease and Intraductal Carcinoma. Am J Dermatopathol 1988;10:183-88.
  • 7. Cohen C, Guarner J, DeRose PB. Mammary Paget's d is e a s e a n d a ss o c i a t e d c a r c i n oma . A n immunohistochemical study. Arch Pathol Lab Med 1993;117:291-94.
  • 8. Kothari AS, Beechey-Newman N, Hamed H, Fentiman IS, D'Arrigo C, Hanby AM. Paget disease of the nipple. A multifocal manifestation of higher-risk disease. Cancer 2002;95:1-7.
  • 9. Chen CY, Sun LM, Anderson BO. Paget disease of the breast: Changing patterns of incidence, clinical presentation, and treatment in the U.S. Cancer 2006;107:1448-58.
  • 10. Vielh P, Validire P, Kheirallah S, Campana F, Fourquet A, Di Bonito L. Paget's disease of the nipple without clinically and radiologically detectable breast tumor. Histochemical and immunohistochemical study of 44 cases. Pathol Res Pract 1993;189:150-5.
  • 11. Sahoo S, Green I, Rosen PP. Bilateral Paget disease of the nipple associated with lobular carcinoma in situ. Arch Pathol Lab Med 2002;126:90-2.
  • 12. Olson JA Jr, Morris EA, Van Zee KJ, Linehan DC, Borgen PI. Magnetic resonance imaging facilitates breast conservation for occult breast cancer. Ann Surg Oncol 2000;7:411-5.
  • 13. Amano G, Yajima M, Moroboshi Y, Kuriya Y, Ohuchi N. MRI accurately depicts underlying DCIS in a patient with Paget's disease of the breast without palpable mass and mammography findings. Jpn J Clin Oncol 2005;35:149-53.
  • 14. Eusebio RB, Deckers PJ. Paget's disease of the nipple￾areola complex: A plea for conservatism. Contemp Surg 1992;40:13-6.
  • 15. Sheen-Chen SM, Chen HS, Chen WJ, Eng HL, Sheen CW, Chou FF. Paget disease of the breast-an easily overlooked disease. J Surg Oncol 2001;76:261-5.
  • 16. Kayar R, Çatal H. Memenin paget hastalığında cerrahi: Ülkemizdeki yaklaşım: Actuel Medicine 2010;18:25- 30.
  • 17. Yim JH, Wick MR, Philpott GW, Norton JA, Doherty GM. Underlying pathology in mammary Paget's disease. Ann Surg Oncol 1997;4:287-92
There are 17 citations in total.

Details

Other ID JA76YG78EY
Journal Section Case Report
Authors

Aykut Soyder This is me

Serdar Özbaş This is me

Füsun Taşkın This is me

Meltem Uslu This is me

Saime İlkören This is me

Muhan Erkuş This is me

Publication Date August 1, 2012
Published in Issue Year 2012 Volume: 13 Issue: 2

Cite

EndNote Soyder A, Özbaş S, Taşkın F, Uslu M, İlkören S, Erkuş M (August 1, 2012) Paget’s Disease of the Breast: A Case Report. Meandros Medical And Dental Journal 13 2 39–42.