title: Cystic hypersecretory carcinoma of the breast with paget disease of the nipple: a diagnostic challenge.
abstract: A unique case of cystic hypersecretory carcinoma in a 48-year-old woman who presented with a tender, palpable abnormality of the lower outer quadrant of her left breast in 2002 is described. Mammographic and ultrasound examinations showed heterogeneous, dense breast tissue with a focal asymmetric density and an ill-defined heterogenous hypoechoic area with anechoic spaces, respectively, that corresponded to the area of palpable abnormality. Although the imaging findings did not change significantly over 4 years, the patient complained of intermittent, spontaneous serous discharge from the left nipple and persistent induration and tenderness in the same area of the left breast. An ultrasound-guided core-needle biopsy of the lesion was performed at the last visit to rule out a malignant process. A left simple mastectomy showed a large multicystic lesion occupying most of the lower quadrants by a cystic hypersecretory carcinoma and Paget disease of the nipple.
authors.affiliation: Department of Pathology, University of Louisville Hospital, Louisville, KY 40202, USA. sunati.sahoo@louisville.edu
authors.forename: Sunati
authors.initials: S
authors.lastname: Sahoo
authors.forename: Purva
authors.initials: P
authors.lastname: Gopal
authors.forename: Lane
authors.initials: L
authors.lastname: Roland
authors.forename: Nancy
authors.initials: N
authors.lastname: Pile
mesh_terms: D001943:Breast Neoplasms / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D002278:Carcinoma in Situ / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D008408:Mastectomy; D008875:Middle Aged; D009558:Nipples / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D010144:Paget's Disease, Mammary / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D016217:Ultrasonography, Mammary