MEMENİN PAGET HASTALIĞI: OLGU SUNUMU
Yıl 2012,
Cilt: 13 Sayı: 2, 39 - 42, 01.08.2012
Aykut Soyder
Serdar Özbaş
Füsun Taşkın
Meltem Uslu
Saime İlkören
Muhan Erkuş
Öz
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
Kaynakça
- 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 nippleareola 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
Yıl 2012,
Cilt: 13 Sayı: 2, 39 - 42, 01.08.2012
Aykut Soyder
Serdar Özbaş
Füsun Taşkın
Meltem Uslu
Saime İlkören
Muhan Erkuş
Öz
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.
Kaynakça
- 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 nippleareola 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