Paget breast cancer immunoprofile as Toker's cells: a case report

Abstract

Background&Objective: Paget's disease or Paget breast cancer is a rare and unusual breast cancer. The appearance of the disease may be associated with invasive or noninvasive tumour mass and rarely without an underlying neoplasm. The aim of this paper is to present a case of Paget’s carcinoma without an underlying carcinoma (PCWUC), arising from Toker's cells. Method: The patient was 70-years old woman with ulcerative and crusted changes of the nipple and areola. We examined a large number of sections taken from biopsy and surgical specimen of the nipple, areola and underlying breast tissue. All slices were processed and stained with standard procedures (haematoxylin–eosin) and immunohistochemical technique. Results: Epidermis and distal lactiferous channels were infiltrated with Paget cells resembling atypical neoplastic altered Toker's cells. Using immunohistochemistry, we found a clear demarcation between normal epithelial cells from malignant cells infiltrate. Cytokeratin 7 was positive only in tumour cells, but high molecular and low molecular weight cytokeratins were only positive in normal epithelial cells. Underlying breast tissue did not contain any tumour cells. Conclusion: The same immunoprofile of Toker's cells and PCWUC cells suggests a common histogenesis.