Pourmoussa Austin J, Mautner Starr K, Nasseri-Nik Niloofar, Lampen-Sachar Katharine
Radiology, Baptist Health South Florida, Miami, USA.
Surgery, Baptist Health South Florida, Miami, USA.
Cureus. 2021 Nov 2;13(11):e19216. doi: 10.7759/cureus.19216. eCollection 2021 Nov.
Paget's disease of the breast is rare among breast cancers. Secondary Paget's disease of the breast presenting as local recurrence is even rarer, with limited published information on the overall prevalence. In this report, we present a case of secondary Paget's disease of the breast presenting as a pruritic rash and skin changes with normal imaging. This patient's case was unique as her presentation involved invasive Paget's disease of the breast presenting as a local recurrence, with a diffuse rash covering the entirety of the right breast including the nipple-areolar complex, pathology examination showing dermal invasion, and a 20-year time interval between her initial treatment and presentation at our institution. Furthermore, diagnostic mammogram and breast MRI revealed no underlying suspicious findings within the breast tissue. In this case, the patient benefitted from mastectomy with removal of the affected skin, resulting in a clear margin and clinically favorable outcome. The patient did well postoperatively, did not receive any systemic adjuvant treatment, and is now under surveillance. Currently, there is insufficient data on the incidence of diffuse Paget's disease of the breast with dermal invasion. It is important to recognize this atypical presentation to ensure timely diagnosis and treatment of affected patients.
佩吉特病在乳腺癌中较为罕见。以局部复发形式出现的继发性乳腺佩吉特病更为罕见，关于其总体患病率的公开信息有限。在本报告中，我们呈现了一例继发性乳腺佩吉特病，表现为瘙痒性皮疹和皮肤改变，而影像学检查正常。该患者的病例较为独特，其表现为侵袭性乳腺佩吉特病以局部复发形式出现，弥漫性皮疹覆盖整个右乳，包括乳头乳晕复合体，病理检查显示真皮侵犯，且在其初始治疗与在我院就诊之间间隔了20年。此外，诊断性乳房X线摄影和乳腺MRI检查显示乳腺组织内无潜在可疑病变。在此病例中，患者接受了乳房切除术并切除了受累皮肤，切缘阴性，临床效果良好。患者术后恢复良好，未接受任何全身辅助治疗，目前处于随访中。目前，关于伴有真皮侵犯的弥漫性乳腺佩吉特病的发病率数据不足。认识到这种非典型表现对于确保受影响患者的及时诊断和治疗很重要。
