Paget’s disease is an in situ adenocarcinoma of the nipple-areola complex (mammary Paget’s disease) or in other areas of the body with apocrine glands (extramammary Paget’s disease). Mammary Paget’s disease is associated in 98% of cases with an in situ or invasive intraductal adenocarcinoma. Clinically it appears as a typical erythematous, eczematoid, unilateral plaque, covered with scales or crusts, sometimes ulcerated, accompanied by serous and/or bloody papillary discharge; it may be associated with itching, pain or burning sensation. The nipple may be ulcerated or retracted. Histopathologically it is characterized by Paget cells, round or ovoid, large-sized cells without tonofilaments, PASpositive, with pale cytoplasm, located in the basal layer. Surgical excision is the best treatment option although recurrences are frequent.
We present the case of a 62-year-old female patient, who requested a dermatological consultation for the appearance of an erythemato-squamous, itchy plaque, located on the right nipple, with scaly surface and regular, polycyclic borders, evolving for several months. The usual laboratory investigations were within normal limits. The highlighting of Paget’s cells at histopathological exam confirm the clinical suspicion of Paget’s mammary disease. The patient was referred to the oncology department for further investigations and the appropriate therapeutic management.