[Pigmented Paget's disease of the male nipple].
BACKGROUND
Mammary Paget's disease unfrequently occurs in males, and may be pigmented in rare instances. Differential diagnosis with malignant melanoma relies on immunohistochemical studies.


METHODS
A case of Paget's disease of the nipple in a 76 year-old male is reported, clinically mimicking a malignant melanoma because of massive pigmentation. Histologically, large Paget's clear cells were intermingled with numerous melanin-rich dendritic melanocytes. An underlying ductal carcinoma was found. After differential immunohistochemical staining, diagnosis of Paget's disease could be unequivocally substantiated since Paget's cells stained for epithelial markers, c-erbB-2 and hormonal receptors, whereas protein S100 and HMB45 were negative.


CONCLUSIONS
Pigmentation in mammary Paget's disease occurs preferentially in males. Pigmentation results from numerous melanocytes with abundant melanin in close contact with Paget's cells. An increased number of melanocytes may also be observed in cutaneous metastatic breast carcinomas. It could result from a chemotactic factor produced by neoplastic cells.
Menet
E
E
Service d'Anatomie et de Cytologie Pathologiques, Centre Hospitalier Universitaire, Poitiers.
Vabres
P
P
Brecheteau
P
P
Bonneau-Herve
F
F
Duport
G
G
Levillain
P
P
Larregue
M
M
Babin
P
P
D000368:Aged; D000951:Antigens, Neoplasm; D014408:Biomarkers, Tumor / Q000097:blood; D018567:Breast Neoplasms, Male / Q000097:blood / Q000276:immunology / Q000473:pathology*; D003937:Diagnosis, Differential; D018734:Genes, erbB-2 / Q000502:physiology; D006801:Humans; D007150:Immunohistochemistry; D007633:Keratins / Q000097:blood; D008297:Male; D008545:Melanoma / Q000097:blood / Q000276:immunology / Q000473:pathology; D058950:Melanoma-Specific Antigens; D009363:Neoplasm Proteins / Q000097:blood; D009558:Nipples; D010144:Paget's Disease, Mammary / Q000097:blood / Q000276:immunology / Q000473:pathology*; D009418:S100 Proteins / Q000097:blood; D012878:Skin Neoplasms / Q000097:blood / Q000276:immunology / Q000473:pathology
D000951:Antigens, Neoplasm; D014408:Biomarkers, Tumor; D058950:Melanoma-Specific Antigens; D009363:Neoplasm Proteins; D009418:S100 Proteins; C110294:S100A1 protein; D007633:Keratins