Departments of Pathology.
Surgical Oncology.
Am J Dermatopathol. 2020 Dec;42(12):981-985. doi: 10.1097/DAD.0000000000001799.
Mammary Paget disease (MPD) comprises 1.45% all male breast cancers, compared with only 0.68% of all female breast cancers. Patients usually present in the fifth and sixth decades of life with ulceration, eczematous changes, discharge, bleeding, itching, and induration of the nipple and areola. Typically, there is a delay in definitive diagnosis and treatment from the onset of symptoms because most patients are initially treated for a rash. At the time of diagnosis, about half of the patients may have palpable breast mass, positive lymph nodes, or both. In this article, we present 2 cases of male MPD representing the extremes of clinical, radiologic, and histopathologic spectrum of the disease. One patient presented with a rash of the nipple of several months duration without an underlying lesion, whereas the other presented with sensitivity and pain of the nipple for 1 year and an underlying mass. Biopsies were diagnostic of MPD in both cases, and definitive surgery revealed an underlying ductal carcinoma in situ in the first case and an invasive ductal carcinoma in the second, highlighting the importance of early biopsy to initiate appropriate management.
乳房派杰病（MPD）占男性乳腺癌的 1.45%，而女性乳腺癌仅占 0.68%。患者通常在第五和第六个十年出现溃疡、湿疹样改变、溢液、出血、瘙痒和乳头乳晕硬结。由于大多数患者最初被误诊为皮疹，因此从症状出现到明确诊断和治疗通常存在延迟。在诊断时，约一半的患者可能有可触及的乳房肿块、阳性淋巴结或两者兼有。在本文中，我们介绍了 2 例男性 MPD 病例，代表了该病临床、影像学和组织病理学表现的极端情况。一例患者表现为数月的乳头皮疹，无潜在病变，另一例患者则表现为乳头敏感和疼痛 1 年，并伴有潜在肿块。两例病例的活检均诊断为 MPD，明确的手术显示第一例患者存在导管原位癌，第二例患者存在浸润性导管癌，这突出了早期活检以启动适当治疗的重要性。
