HER2 Negative Mammary Paget's Disease or In Situ Melanoma? A Case Report and Review of the Literature.
Journal
Case reports in pathology
ISSN: 2090-6781
Titre abrégé: Case Rep Pathol
Pays: United States
ID NLM: 101576609
Informations de publication
Date de publication:
2023
2023
Historique:
received:
09
05
2022
revised:
13
03
2023
accepted:
10
05
2023
medline:
1
6
2023
pubmed:
1
6
2023
entrez:
1
6
2023
Statut:
epublish
Résumé
Mammary Paget's disease (MPD) is a rare histological condition, accounting for 1-4% of female breast cancers, which may appear either independently (1.4-13% of the cases), or in association with an in situ or invasive ductal carcinoma (approximately 90% of the cases). The purpose of this article is to highlight the histopathological challenges related to the microscopical polymorphism of this disease and the utmost importance of immunohistochemistry in the thorough process of Paget's disease differential diagnosis. Moreover, the primary objective of this review of literature was to corroborate the existing data concerning the potential peculiar immunohistochemical profile that mammary Paget's disease might express. We report the case of a 44-year-old female patient, histopathologically diagnosed with HER2-negative MPD accompanying an invasive mammary carcinoma. The histopathological and immunohistochemical approach is derived from the exigency of excluding the possibility of synchronous tumors-a mammary invasive carcinoma, accompanied by another component with MPD phenotypic mimicry. The unexpected negative HER2 reaction is conducted to a primary focus on excluding a malignant melanoma in situ. The absence of MelanA and S100 immunoexpression and lack of pigmentation and clinical aspects infirmed it. Bowen's disease was invalidated by its rare presentation in the breast cutaneous tissue and the absence of individual risk factors suggestive of an existing immunosuppressive status. In the case of similar morphoimmunohistochemical aspects, significant expression of Ki-67 signals MPD, an immunoreactivity that helped distinguish the cellular population from Toker cells. The great similarity of MPD with other benign and malignant cutaneous tumors might determine delay or misdiagnosis. Thus, the utmost importance of immunohistochemistry is reflected in its prognostic significance and geared towards extending the therapeutic arsenal.
Identifiants
pubmed: 37260825
doi: 10.1155/2023/1101130
pmc: PMC10229244
doi:
Types de publication
Case Reports
Langues
eng
Pagination
1101130Informations de copyright
Copyright © 2023 Luana-Andreea Boșoteanu et al.
Déclaration de conflit d'intérêts
The authors declare that they have no conflict of interest.
Références
Br J Dermatol. 1984 Feb;110(2):203-10
pubmed: 6320859
Breast Cancer Res Treat. 2008 Dec;112(3):513-21
pubmed: 18240020
Cancer Med. 2019 Jul;8(8):4043-4054
pubmed: 31134761
Front Med (Lausanne). 2022 Mar 21;9:839954
pubmed: 35386919
J Am Acad Dermatol. 2011 Jul;65(1):247-9
pubmed: 21679843
J Eur Acad Dermatol Venereol. 2007 May;21(5):581-90
pubmed: 17447970
Breast J. 2006 May-Jun;12(3):233-6
pubmed: 16684321
Cancer. 2002 Jul 1;95(1):1-7
pubmed: 12115309
Am J Dermatopathol. 2015 Apr;37(4):261-5; quiz 266-8
pubmed: 25794368
J Carcinog. 2011;10:31
pubmed: 22279416
Ann Dermatol. 2014 Dec;26(6):747-50
pubmed: 25473229
J Surg Oncol. 2001 Jul;77(3):171-8
pubmed: 11455553
J Clin Pathol. 2000 Oct;53(10):742-9
pubmed: 11064666
Pathology. 2009;41(7):640-4
pubmed: 20001343
Int J Dermatol. 2010 Jan;49(1):59-61
pubmed: 20465614
J Clin Oncol. 2009 Mar 10;27(8):1168-76
pubmed: 19204205
Front Surg. 2017 Oct 23;4:51
pubmed: 29109950
Virchows Arch. 1996 Dec;429(6):371-6
pubmed: 8982382
Clin Breast Cancer. 2009 Feb;9(1):53-5
pubmed: 19299242
Am J Surg Pathol. 1999 Feb;23(2):212-9
pubmed: 9989849
Mod Pathol. 2005 Oct;18(10):1283-8
pubmed: 15920545
Saudi Med J. 2020 Mar;41(3):232-237
pubmed: 32114594
J Cutan Pathol. 2008 May;35(5):433-44
pubmed: 18399807