BACKGROUND:

The Paget´s disease mammary is an uncommon malignancy that presents with changes in the nipple-areolar region that may be associated with an underlying breast cancer.

CLINICAL CASE:

A 69-year-old patient with a breast lesion of three years of evolution, changes in nipple, characterized by coloration and scaling, pruritus, with an erythematous and scaly appearance in the nipple-areola left region, and nipple retraction. A biopsy of the nipple-areola was obtained. The Pathology service reported large neoplastic cells, with infiltration to the epidermis, isolated or in small groups, with clear cytoplasm, vacuolated, enlarged nucleus and prominent nucleolus, characteristic of Paget's disease mammary. The immunohistochemistry study reported positivity for CK7 and HER2, and negativity for p53 to neoplastic cells, which established the definitive diagnosis of Paget's disease of the breast. The mammography was normal and the mastectomy reported intraductal carcinoma.

CONCLUSION:

The knowledge of mammary Paget's disease is of clinical importance, since it represents a rare condition, which must be considered in the differential diagnosis of benign lesions of the areola-nipple complex.