case_images: PMC9893054_01
case_images: Clinical photograph showing nipple-areolar ulcer on right breast.
case_images: 10.1177_2050313X231151753-fig1.jpg
case_images: PMC9893054_01_10.1177_2050313X231151753-fig1.jpg
case_images: fig1-2050313X231151753
case_images: Breast examination revealed an eczematous lesion confined to the right nipple associated with an ulcer on the areola (no nipple appreciated) measuring 2 x 4 cm and non-tender (Figure 1).
case_images: Plain chest X-ray showing "cannon-ball" lesions.
case_images: 10.1177_2050313X231151753-fig2.jpg
case_images: PMC9893054_01_10.1177_2050313X231151753-fig2.jpg
case_images: fig2-2050313X231151753
case_images: There were normal findings on the abdominal pelvic ultrasound, but her plain chest X-ray showed cannonball appearance suggestive of lung metastasis (Figure 2).
case_images: (a) Histopathology of Paget's disease of the breast displaying single or clusters of cells spread throughout the epidermis; underlying dermis has chronic inflammation (H&E 100 x original magnification). (b) Photomicroscopy highlighting high power of the Paget cells with abundant pale cytoplasm, large irregular nuclei with prominent nucleoli (H&E 200 x original magnification).
case_images: 10.1177_2050313X231151753-fig3.jpg
case_images: PMC9893054_01_10.1177_2050313X231151753-fig3.jpg
case_images: fig3-2050313X231151753
case_images: The histology report of the breast tissue biopsy revealed PD of the nipple (Figure 3) and the core biopsy of the mass revealed infiltrating ductal carcinoma and Nottingham score 7/9, positive for ER (estrogen receptor) and PR (progesterone receptor) but negative for HER-2, and her metastasis stage was cT4N0M1.