Paget’s disease Of the Breast and Ductal Carcinoma in Situ; Case Report

Öz

Purpose: A case with no clinical signs of a breast mass and an macroscopic evidence of Paget's disease in the mastectomy material is reported. Material Method: Although eczematous nipple changes for 24 months were present in sixty year old woman, clinically, a palpable breast mass was not determined. After the incisional biopsy of right nipple was reported as Paget's disease of the breast, modified radical mastectomy was performed. The tissue sampling was appropriately done in macroscopical examination. After the routine tissue processing and staining procedure, the tissue sections were examined under the light microscopy. Findings: In macroscopical examination of the right mastectomy material, any occupied lesion was noted. When macroscopical examination was continued by thin slices, punctuated calcifications in a 10x9 millimeter area were noted in upper outside quadrant. Two separate foci of ductal carcinoma in situ in both of upper outside and lower inner quadrants were determined in microscopical examination. Metastatic lymph node was not present in axillary dissection material. Result: An underlying breast mass can not present in Paget's disease of the breast or the mass can be too small to determine. Furthermore, the tumoral focus can also be in character of ductal carcinoma in situ. For this reason, when the mastectomy materials of the cases of Paget's disease of the breast are evaluated, it should be kept in mind that only ductal carcinoma in situ focus could be found in mastectomy material as the underlying tumoral lesion in Paget's disease of the breast. Key words: Mammary Paget's disease, Ductal carcinoma in situ, Paget's cells

Anahtar Kelimeler

• Mammary Paget's disease, Ductal carcinoma in situ, Paget's cells

Memenin Paget Hastalığı ve Duktal Karsinoma İn Situ: Olgu Sunumu +

Öz

Amaç:Memenin Paget hastalığında ele gelir bir meme kitlesinin saptanmama ve mastektomi materyalinin makroskopik incelemesinde yer kaplayan bir lezyonun görülmeme olasılığı nedeni ile olguyu takdim ediyorum. Gereç ve Yöntem: Altmış yaşındaki kadın hastanın 24 aydır sağ meme başında yaygın ekzematöz değişiklikleri olmakla birlikte klinik olarak ele gelen bir meme kitlesi mevcut değildi. Sağ meme başından yapılan insizyonel biyopsi “memenin Paget hastalığı” olarak rapor edildikten sonra modifiye radikal mastektomi uygulandı. Makroskopik inceleme sonrası alınan örnekler rutin doku takip ve boyama işlemlerinden sonra ışık mikroskobunda incelendi. Bulgular: Mastektomi materyalinin makroskopik incelemesinde herhangi bir yer kaplayıcı lezyon dikkati çekmedi. İnce dilimler halinde incelemeye devam edildiğinde üst dış kadranda 10x9 mm'lik bir alanda noktasal kalsifikasyonlar izlendi. Mikroskopik incelemede biri üst dış kadranda diğeri alt iç kadranda iki ayrı odak halinde duktal karsinoma in situ saptandı. Aksiller lenf düğümlerinde metastaz mevcut değildi. Sonuç: Meme başının Paget hastalığında altta yatan bir meme kitlesi olmayabilir ya da kitle saptanamayacak kadar küçük olabilir. Bununla birlikte tümöral odak duktal karsinoma in situ özelliğinde dahi olabilmektedir. Bu nedenle memenin Paget hastalığı tanısı konan olguların mastektomi materyalleri değerlendirilir iken atlanabilecek küçük tümör ya da duktal karsinoma in situ odaklarının olabileceği akılda tutulmalıdır. Anahtar kelimeler: Memenin Paget hastalığı, Duktal karsinoma in situ, Paget hücreleri

Anahtar Kelimeler

• Memenin Paget hastalığı, Duktal karsinoma in situ, Paget hücreleri

Kaynakça

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