Abstract and Introduction
Abstract
Introduction: Paget's disease is an eczematous skin change of the nipple that is usually associated with an underlying breast malignancy. Male breast cancer represents only 1–3% of all breast malignancies and Paget's disease remains very rare.
Case presentation: We present the case of a 67-year-old Caucasian man with lymphomatoid papulosis who was diagnosed with Paget's disease of the nipple and who was treated successfully with surgery alone. We discuss the presentation, investigations, management and pathogenesis of Paget's disease of the nipple.
Conclusion: The case highlights the need to be vigilant when new skin lesions arise in the context of an underlying chronic skin disorder.
Introduction
Paget's disease is an eczematous skin change of the nipple that is usually associated with an underlying breast malignancy. It may present with erythema, scaling, ulceration, bleeding or a painful nipple. Male breast cancer accounts for less than 1% of all breast cancer with Paget's disease remaining very rare. Paget's disease of the nipple may be associated with an underlying invasive cancer, a non-invasive cancer ductal carcinoma in situ or no underlying cancer. Prognosis is dependent upon the status of invasion and treatment is tailored accordingly. Approximately 90% of patients presenting with a palpable mass or who have a visible mass on mammography will have underlying invasive disease. Notably, invasive cancer can occur with Paget's disease in 38% of patients with no underlying mass.