Mammary Paget Disease With Melanocytic Proliferation Mimicking Malignant Melanoma in situ: A Case Report

Shijia Rao; Alun Wang; Wei Liu; Hongling Yin; Ji Li; Lemuel Shui-Lun Tsang; Yuhui Wu; Wei Shi

doi:10.3389/fmed.2022.839954

Mammary Paget Disease With Melanocytic Proliferation Mimicking Malignant Melanoma in situ: A Case Report

Front Med (Lausanne). 2022 Mar 21:9:839954. doi: 10.3389/fmed.2022.839954. eCollection 2022.

Authors

Shijia Rao¹, Alun Wang², Wei Liu³, Hongling Yin⁴, Ji Li⁵, Lemuel Shui-Lun Tsang⁶, Yuhui Wu⁷, Wei Shi⁵

Affiliations

¹ Department of Dermatology, The Second Xiangya Hospital, Central South University, Changsha, China.
² Department of Pathology, Tulane University School of Medicine, New Orleans, LA, United States.
³ Department of Oncology, Xiangya Hospital, Central South University, Changsha, China.
⁴ Department of Pathology, Xiangya Hospital, Central South University, Changsha, China.
⁵ Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China.
⁶ College of Medicine, The University of Tennessee Health Science Center, Memphis, TN, United States.
⁷ Department of Breast Surgery, Xiangya Hospital, Central South University, Changsha, China.

Abstract

Several cases of pigmented mammary Paget's disease (PMPD) mimicking cutaneous malignant melanoma have been reported. In these cases, the tumor cells are colonized by melanocytes, particularly with the presence of a population of melanocytes staining for HMB-45 and S100. Here, we report a case of mammary Paget disease (MPD) which was misdiagnosed as melanoma in situ due to the interpretation of the staining of melanocytic markers S-100, Melan-A, and HMB-45. The tumor cells strongly expressed CK7 and GATA3, and a dual-labeling showed negative PHH3 labeling for the melanocytes. Pathologists need to be aware of the caveat of colonization of melanocytes in Paget disease.

Keywords: dermatology; mammary Paget disease; melanocytic proliferation; melanoma in situ; pathology.

Publication types

Case Reports