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February 1956

Paget's Disease of the NippleReview of Twenty-Five Cases with Special Reference to Melanin Pigmentation of "Paget Cells"

AMA Arch Surg. 1956;72(2):224-231. doi:10.1001/archsurg.1956.01270200040008

Although it has been pointed out that some lesions diagnosed as extramammary Paget's disease may in reality be superficial malignant melanomas,9 it is apparently not generally appreciated that mammary Paget's disease may also simulate malignant melanoma in its histologic appearance. We were confronted with this diagnostic problem when we recently encountered Case 22 of the present series. The patient's complaint was itching of the nipple, and the nipple seemed firmer and more deeply pigmented than normal. It did not have the eczematoid appearance commonly seen in Paget's disease. The problem was subsequently resolved by the demonstration, on serial sectioning of the subareolar area, of a tiny focus of intraductal carcinoma and by the appearance within two weeks of a second, somewhat similar case. In the latter the histologic appearance of the nipple was nearly identical with that of the first case, although the nipple was crusted. This lesion was

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