Pigmented mammary Paget's disease mimicking melanoma
Università degli Studi di Trieste, Trst, Friuli Venezia Giulia, ItalyMelanoma Research (Impact Factor: 2.28). 05/2004; 14(2):S13-5. DOI: 10.1097/00008390-200404000-00017
Our case of pigmented mammary Paget's disease simulated melanoma clinically and dermoscopically. Histologically, the lesion was characterized by microscopic features similar to those seen in malignant melanoma and, to a lesser extent, in Bowen's disease (intra-epidermal squamous cell carcinoma). Immunohistochemical studies demonstrated that the tumor cells were positive for keratins (Cam 5.2+MNF 116) and AE1-AE3 and negative for HMB-45 and S-100 proteins. In conclusion clinical and dermoscopic examination cannot reliably distinguish melanoma from epithelial pre-neoplastic or neoplastic disease, therefore the differentiation of pigmented Paget's disease from superficial spreading of melanoma and Bowen's disease is based on histopathologic integrated with immunohistochemical criteria.
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ABSTRACT: Extramammary Paget's disease is a neoplastic disease, which usually manifests as an erythematous plaque on the genital area. Pigmented extramammary Paget's disease is a rare variant. It should be differentiated from malignant melanoma. We report a case of pigmented extramammary Paget's disease in a 62-year-old male who had a brown-to-black or erythematous-colored plaque on the scrotum and inguinal area. Histopathologic findings showed features typical to extramammary Paget's disease, with proliferation of epidermal melanocytes and dermal melanin pigments.
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