Skip to main content
PMC home page
Journal of Clinical Pathology logoLink to Journal of Clinical Pathology
. 2000 Oct;53(10):742–749. doi: 10.1136/jcp.53.10.742

Mammary and extramammary Paget's disease

J Lloyd 1, A Flanagan 1
PMCID: PMC1731095  PMID: 11064666

Abstract

Mammary and extramammary Paget's disease are uncommon intraepithelial adenocarcinomas. Both conditions have similar clinical features, which mimic inflammatory and infective diseases. Histological diagnostic confusion can arise between Paget's disease and other neoplastic conditions affecting the skin, with the most common differential diagnoses being malignant melanoma and atypical squamous disease. The glandular differentiation of both mammary Paget's disease and extramammary Paget's disease is indicated by morphological appearances, the presence of intracellular mucin in many cases, and positive immunohistochemical staining for glandular cytokeratins, epithelial membrane antigen, and carcinoembryonic antigen. This article provides an overview of mammary and extramammary Paget's disease and discusses recent evidence regarding the cell of origin. The concepts of primary and secondary Paget's disease are presented and the differential diagnosis is discussed with reference to immunohistochemical markers that might be of diagnostic value.

Key Words: mammary Paget's disease • extramammary Paget's disease

Full Text

The Full Text of this article is available as a PDF (121.2 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Allan S. J., McLaren K., Aldridge R. D. Paget's disease of the scrotum: a case exhibiting positive prostate-specific antigen staining and associated prostatic adenocarcinoma. Br J Dermatol. 1998 Apr;138(4):689–691. doi: 10.1046/j.1365-2133.1998.02187.x. [DOI] [PubMed] [Google Scholar]
  2. Bacchi C. E., Goldfogel G. A., Greer B. E., Gown A. M. Paget's disease and melanoma of the vulva. Use of a panel of monoclonal antibodies to identify cell type and to microscopically define adequacy of surgical margins. Gynecol Oncol. 1992 Aug;46(2):216–221. doi: 10.1016/0090-8258(92)90258-k. [DOI] [PubMed] [Google Scholar]
  3. Bergen S., DiSaia P. J., Liao S. Y., Berman M. L. Conservative management of extramammary Paget's disease of the vulva. Gynecol Oncol. 1989 May;33(2):151–156. doi: 10.1016/0090-8258(89)90541-6. [DOI] [PubMed] [Google Scholar]
  4. Besa P., Rich T. A., Delclos L., Edwards C. L., Ota D. M., Wharton J. T. Extramammary Paget's disease of the perineal skin: role of radiotherapy. Int J Radiat Oncol Biol Phys. 1992;24(1):73–78. doi: 10.1016/0360-3016(92)91024-h. [DOI] [PubMed] [Google Scholar]
  5. Bulens P., Vanuytsel L., Rijnders A., van der Schueren E. Breast conserving treatment of Paget's disease. Radiother Oncol. 1990 Apr;17(4):305–309. doi: 10.1016/0167-8140(90)90004-g. [DOI] [PubMed] [Google Scholar]
  6. Burke E. T., Braeuning M. P., McLelland R., Pisano E. D., Cooper L. L. Paget disease of the breast: a pictorial essay. Radiographics. 1998 Nov-Dec;18(6):1459–1464. doi: 10.1148/radiographics.18.6.9821194. [DOI] [PubMed] [Google Scholar]
  7. Burrows N. P., Jones D. H., Hudson P. M., Pye R. J. Treatment of extramammary Paget's disease by radiotherapy. Br J Dermatol. 1995 Jun;132(6):970–972. doi: 10.1111/j.1365-2133.1995.tb16957.x. [DOI] [PubMed] [Google Scholar]
  8. Campana F., Vielh P., Fourquet A., Schlienger P., Jullien D., Durand J. C., Salmon R., Vilcoq J. R. Maladie de Paget du mamelon sans tumeur mammaire associée cliniquement ou radiologiquement décelable. A propos de 51 cas traités à l'Institut Curie. J Gynecol Obstet Biol Reprod (Paris) 1987;16(8):1069–1073. [PubMed] [Google Scholar]
  9. Cappuccini F., Tewari K., Rogers L. W., DiSaia P. J. Extramammary Paget's disease of the vulva: metastases to the bone marrow in the absence of an underlying adenocarcinoma--case report and literature review. Gynecol Oncol. 1997 Jul;66(1):146–150. doi: 10.1006/gyno.1997.4735. [DOI] [PubMed] [Google Scholar]
  10. Cohen C., Guarner J., DeRose P. B. Mammary Paget's disease and associated carcinoma. An immunohistochemical study. Arch Pathol Lab Med. 1993 Mar;117(3):291–294. [PubMed] [Google Scholar]
  11. Coldiron B. M., Goldsmith B. A., Robinson J. K. Surgical treatment of extramammary Paget's disease. A report of six cases and a reexamination of Mohs micrographic surgery compared with conventional surgical excision. Cancer. 1991 Feb 15;67(4):933–938. doi: 10.1002/1097-0142(19910215)67:4<933::aid-cncr2820670413>3.0.co;2-3. [DOI] [PubMed] [Google Scholar]
  12. Costello T. J., Wang H. H., Schnitt S. J., Ritter R., Antonioli D. A. Paget's disease with extensive involvement of the female genital tract initially detected by cervical cytosmear. Arch Pathol Lab Med. 1988 Sep;112(9):941–944. [PubMed] [Google Scholar]
  13. Crawford D., Nimmo M., Clement P. B., Thomson T., Benedet J. L., Miller D., Gilks C. B. Prognostic factors in Paget's disease of the vulva: a study of 21 cases. Int J Gynecol Pathol. 1999 Oct;18(4):351–359. doi: 10.1097/00004347-199910000-00010. [DOI] [PubMed] [Google Scholar]
  14. Curtin J. P., Rubin S. C., Jones W. B., Hoskins W. J., Lewis J. L., Jr Paget's disease of the vulva. Gynecol Oncol. 1990 Dec;39(3):374–377. doi: 10.1016/0090-8258(90)90269-q. [DOI] [PubMed] [Google Scholar]
  15. Desai D. C., Brennan E. J., Jr, Carp N. Z. Paget's disease of the male breast. Am Surg. 1996 Dec;62(12):1068–1072. [PubMed] [Google Scholar]
  16. Evans A. T., Neven P. Invasive adenocarcinoma arising in extramammary Paget's disease of the vulva. Histopathology. 1991 Apr;18(4):355–360. doi: 10.1111/j.1365-2559.1991.tb00857.x. [DOI] [PubMed] [Google Scholar]
  17. Fanning J., Lambert H. C., Hale T. M., Morris P. C., Schuerch C. Paget's disease of the vulva: prevalence of associated vulvar adenocarcinoma, invasive Paget's disease, and recurrence after surgical excision. Am J Obstet Gynecol. 1999 Jan;180(1 Pt 1):24–27. doi: 10.1016/s0002-9378(99)70143-2. [DOI] [PubMed] [Google Scholar]
  18. Fishman D. A., Chambers S. K., Schwartz P. E., Kohorn E. I., Chambers J. T. Extramammary Paget's disease of the vulva. Gynecol Oncol. 1995 Feb;56(2):266–270. doi: 10.1006/gyno.1995.1044. [DOI] [PubMed] [Google Scholar]
  19. Fligiel Z., Kaneko M. Extramammary Paget's disease of the external ear canal in association with ceruminous gland carcinoma. A case report. Cancer. 1975 Sep;36(3):1072–1076. doi: 10.1002/1097-0142(197509)36:3<1072::aid-cncr2820360334>3.0.co;2-w. [DOI] [PubMed] [Google Scholar]
  20. Fourquet A., Campana F., Vielh P., Schlienger P., Jullien D., Vilcoq J. R. Paget's disease of the nipple without detectable breast tumor: conservative management with radiation therapy. Int J Radiat Oncol Biol Phys. 1987 Oct;13(10):1463–1465. doi: 10.1016/0360-3016(87)90311-7. [DOI] [PubMed] [Google Scholar]
  21. Geisler J. P., Gates R. W., Shirrell W., Parker S. M., Maloney C. D., Wiemann M. C., Geisler H. E. Extramammary Paget's disease with diffuse involvement of the lower female genito-urinary system. Int J Gynecol Cancer. 1997 Jan;7(1):84–87. doi: 10.1046/j.1525-1438.1997.00405.x. [DOI] [PubMed] [Google Scholar]
  22. Gillett C. E., Bobrow L. G., Millis R. R. S100 protein in human mammary tissue--immunoreactivity in breast carcinoma, including Paget's disease of the nipple, and value as a marker of myoepithelial cells. J Pathol. 1990 Jan;160(1):19–24. doi: 10.1002/path.1711600106. [DOI] [PubMed] [Google Scholar]
  23. Goldblum J. R., Hart W. R. Perianal Paget's disease: a histologic and immunohistochemical study of 11 cases with and without associated rectal adenocarcinoma. Am J Surg Pathol. 1998 Feb;22(2):170–179. doi: 10.1097/00000478-199802000-00004. [DOI] [PubMed] [Google Scholar]
  24. Goldblum J. R., Hart W. R. Vulvar Paget's disease: a clinicopathologic and immunohistochemical study of 19 cases. Am J Surg Pathol. 1997 Oct;21(10):1178–1187. doi: 10.1097/00000478-199710000-00008. [DOI] [PubMed] [Google Scholar]
  25. Guarner J., Cohen C., DeRose P. B. Histogenesis of extramammary and mammary Paget cells. An immunohistochemical study. Am J Dermatopathol. 1989 Aug;11(4):313–318. doi: 10.1097/00000372-198908000-00004. [DOI] [PubMed] [Google Scholar]
  26. Guldhammer B., Nørgaard T. The differential diagnosis of intraepidermal malignant lesions using immunohistochemistry. Am J Dermatopathol. 1986 Aug;8(4):295–301. doi: 10.1097/00000372-198608000-00004. [DOI] [PubMed] [Google Scholar]
  27. Hayashibara Y., Ikeda S. [Extramammary Paget's disease with internal malignancies]. Gan To Kagaku Ryoho. 1988 Apr;15(4 Pt 2-3):1569–1575. [PubMed] [Google Scholar]
  28. Helm K. F., Goellner J. R., Peters M. S. Immunohistochemical stains in extramammary Paget's disease. Am J Dermatopathol. 1992 Oct;14(5):402–407. doi: 10.1097/00000372-199210000-00005. [DOI] [PubMed] [Google Scholar]
  29. Hitchcock A., Topham S., Bell J., Gullick W., Elston C. W., Ellis I. O. Routine diagnosis of mammary Paget's disease. A modern approach. Am J Surg Pathol. 1992 Jan;16(1):58–61. doi: 10.1097/00000478-199201000-00008. [DOI] [PubMed] [Google Scholar]
  30. Husseinzadeh N., Recinto C. Frequency of invasive cancer in surgically excised vulvar lesions with intraepithelial neoplasia (VIN 3). Gynecol Oncol. 1999 Apr;73(1):119–120. doi: 10.1006/gyno.1998.5327. [DOI] [PubMed] [Google Scholar]
  31. Jones R. E., Jr, Austin C., Ackerman A. B. Extramammary Paget's disease. A critical reexamination. Am J Dermatopathol. 1979 Summer;1(2):101–132. doi: 10.1097/00000372-197900120-00002. [DOI] [PubMed] [Google Scholar]
  32. Jones R. E., Jr Mammary Paget's disease without underlying carcinoma. Am J Dermatopathol. 1985 Aug;7(4):361–365. doi: 10.1097/00000372-198508000-00009. [DOI] [PubMed] [Google Scholar]
  33. Jones R. R., Spaull J., Gusterson B. The histogenesis of mammary and extramammary Paget's disease. Histopathology. 1989 Apr;14(4):409–416. doi: 10.1111/j.1365-2559.1989.tb02169.x. [DOI] [PubMed] [Google Scholar]
  34. Kakinuma H., Iwasawa U., Kurakata N., Suzuki H. A case of extramammary Paget's disease with depigmented macules as the sole manifestation. Br J Dermatol. 1994 Jan;130(1):102–105. doi: 10.1111/j.1365-2133.1994.tb06892.x. [DOI] [PubMed] [Google Scholar]
  35. Kanitakis J., Thivolet J., Claudy A. p53 protein expression in mammary and extramammary Paget's disease. Anticancer Res. 1993 Nov-Dec;13(6B):2429–2433. [PubMed] [Google Scholar]
  36. Keatings L., Sinclair J., Wright C., Corbett I. P., Watchorn C., Hennessy C., Angus B., Lennard T., Horne C. H. c-erbB-2 oncoprotein expression in mammary and extramammary Paget's disease: an immunohistochemical study. Histopathology. 1990 Sep;17(3):243–247. doi: 10.1111/j.1365-2559.1990.tb00714.x. [DOI] [PubMed] [Google Scholar]
  37. Kirkham N., Berry N., Jones D. B., Taylor-Papadimitriou J. Paget's disease of the nipple. Immunohistochemical localization of milk fat globule membrane antigens. Cancer. 1985 Apr 1;55(7):1510–1512. doi: 10.1002/1097-0142(19850401)55:7<1510::aid-cncr2820550716>3.0.co;2-g. [DOI] [PubMed] [Google Scholar]
  38. Kodama S., Kaneko T., Saito M., Yoshiya N., Honma S., Tanaka K. A clinicopathologic study of 30 patients with Paget's disease of the vulva. Gynecol Oncol. 1995 Jan;56(1):63–70. doi: 10.1006/gyno.1995.1010. [DOI] [PubMed] [Google Scholar]
  39. Koga F., Gotoh S., Suzuki S. [A case of invasive bladder cancer with Pagetoid skin lesion of the vulva and anogenital Paget's disease]. Nihon Hinyokika Gakkai Zasshi. 1997 Apr;88(4):503–506. doi: 10.5980/jpnjurol1989.88.503. [DOI] [PubMed] [Google Scholar]
  40. Kollmorgen D. R., Varanasi J. S., Edge S. B., Carson W. E., 3rd Paget's disease of the breast: a 33-year experience. J Am Coll Surg. 1998 Aug;187(2):171–177. doi: 10.1016/s1072-7515(98)00143-4. [DOI] [PubMed] [Google Scholar]
  41. Lagios M. D., Westdahl P. R., Rose M. R., Concannon S. Paget's disease of the nipple. Alternative management in cases without or with minimal extent of underlying breast carcinoma. Cancer. 1984 Aug 1;54(3):545–551. doi: 10.1002/1097-0142(19840801)54:3<545::aid-cncr2820540327>3.0.co;2-m. [DOI] [PubMed] [Google Scholar]
  42. Lee J. Y., Chao S. C. Clear cell papulosis of the skin. Br J Dermatol. 1998 Apr;138(4):678–683. doi: 10.1046/j.1365-2133.1998.02185.x. [DOI] [PubMed] [Google Scholar]
  43. Lee S. C., Roth L. M., Ehrlich C., Hall J. A. Extramammary Paget's disease of the vulva. A clinicopathologic study of 13 cases. Cancer. 1977 Jun;39(6):2540–2549. doi: 10.1002/1097-0142(197706)39:6<2540::aid-cncr2820390635>3.0.co;2-1. [DOI] [PubMed] [Google Scholar]
  44. Lloveras B., Googe P. B., Goldberg D. E., Bhan A. K. Estrogen receptors in skin appendage tumors and extramammary Paget's disease. Mod Pathol. 1991 Jul;4(4):487–490. [PubMed] [Google Scholar]
  45. Lloyd J., Evans D. J., Flanagan A. M. Extension of extramammary Paget disease of the vulva to the cervix. J Clin Pathol. 1999 Jul;52(7):538–540. doi: 10.1136/jcp.52.7.538. [DOI] [PMC free article] [PubMed] [Google Scholar]
  46. Lundquist K., Kohler S., Rouse R. V. Intraepidermal cytokeratin 7 expression is not restricted to Paget cells but is also seen in Toker cells and Merkel cells. Am J Surg Pathol. 1999 Feb;23(2):212–219. doi: 10.1097/00000478-199902000-00011. [DOI] [PubMed] [Google Scholar]
  47. Mazoujian G., Pinkus G. S., Haagensen D. E., Jr Extramammary Paget's disease--evidence for an apocrine origin. An immunoperoxidase study of gross cystic disease fluid protein-15, carcinoembryonic antigen, and keratin proteins. Am J Surg Pathol. 1984 Jan;8(1):43–50. [PubMed] [Google Scholar]
  48. McKee P. H., Hertogs K. T. Endocervical adenocarcinoma and vulval Paget's disease: a significant association. Br J Dermatol. 1980 Oct;103(4):443–448. doi: 10.1111/j.1365-2133.1980.tb07269.x. [DOI] [PubMed] [Google Scholar]
  49. Meissner K., Rivière A., Haupt G., Löning T. Study of neu-protein expression in mammary Paget's disease with and without underlying breast carcinoma and in extramammary Paget's disease. Am J Pathol. 1990 Dec;137(6):1305–1309. [PMC free article] [PubMed] [Google Scholar]
  50. Molinie V., Paniel B. J., Lessana-Leibowitch M., Moyal-Barracco M., Pelisse M., Escande J. P. Maladie de Paget vulvaire: 36 cas. Ann Dermatol Venereol. 1993;120(8):522–527. [PubMed] [Google Scholar]
  51. Mori O., Hachisuka H., Nakano S., Sasai Y., Shiku H. Expression of ras p21 in mammary and extramammary Paget's disease. Arch Pathol Lab Med. 1990 Aug;114(8):858–861. [PubMed] [Google Scholar]
  52. Nakamura G., Shikata N., Shoji T., Hatano T., Hioki K., Tsubura A. Immunohistochemical study of mammary and extramammary Paget's disease. Anticancer Res. 1995 Mar-Apr;15(2):467–470. [PubMed] [Google Scholar]
  53. Nakano S., Narita R., Tabaru A., Ogami Y., Otsuki M. Bile duct cancer associated with extramammary Paget's disease. Am J Gastroenterol. 1995 Mar;90(3):507–508. [PubMed] [Google Scholar]
  54. Nowak M. A., Guerriere-Kovach P., Pathan A., Campbell T. E., Deppisch L. M. Perianal Paget's disease: distinguishing primary and secondary lesions using immunohistochemical studies including gross cystic disease fluid protein-15 and cytokeratin 20 expression. Arch Pathol Lab Med. 1998 Dec;122(12):1077–1081. [PubMed] [Google Scholar]
  55. Olson D. J., Fujimura M., Swanson P., Okagaki T. Immunohistochemical features of Paget's disease of the vulva with and without adenocarcinoma. Int J Gynecol Pathol. 1991;10(3):285–295. doi: 10.1097/00004347-199107000-00007. [DOI] [PubMed] [Google Scholar]
  56. Ordóez N. G., Awalt H., Mackay B. Mammary and extramammary Paget's disease. An immunocytochemical and ultrastructural study. Cancer. 1987 Mar 15;59(6):1173–1183. doi: 10.1002/1097-0142(19870315)59:6<1173::aid-cncr2820590624>3.0.co;2-r. [DOI] [PubMed] [Google Scholar]
  57. Paone J. F., Baker R. R. Pathogenesis and treatment of Paget's disease of the breast. Cancer. 1981 Aug 1;48(3):825–829. doi: 10.1002/1097-0142(19810801)48:3<825::aid-cncr2820480326>3.0.co;2-#. [DOI] [PubMed] [Google Scholar]
  58. Popiolek D. A., Hajdu S. I., Gal D. Synchronous Paget's disease of the vulva and breast. Gynecol Oncol. 1998 Oct;71(1):137–140. doi: 10.1006/gyno.1998.5136. [DOI] [PubMed] [Google Scholar]
  59. Powell F. C., Bjornsson J., Doyle J. A., Cooper A. J. Genital Paget's disease and urinary tract malignancy. J Am Acad Dermatol. 1985 Jul;13(1):84–90. doi: 10.1016/s0190-9622(85)70148-x. [DOI] [PubMed] [Google Scholar]
  60. Reed W., Oppedal B. R., Eeg Larsen T. Immunohistology is valuable in distinguishing between Paget's disease, Bowen's disease and superficial spreading malignant melanoma. Histopathology. 1990 Jun;16(6):583–588. doi: 10.1111/j.1365-2559.1990.tb01163.x. [DOI] [PubMed] [Google Scholar]
  61. Roth L. M., Lee S. C., Ehrlich C. E. Paget's disease of the vulva. A histogenetic study of five cases including ultrastructural observations and review of the literature. Am J Surg Pathol. 1977 Sep;1(3):193–206. doi: 10.1097/00000478-197709000-00001. [DOI] [PubMed] [Google Scholar]
  62. Samarasinghe D., Frost F., Sterrett G., Whitaker D., Ingram D., Sheiner H. Cytological diagnosis of Paget's disease of the nipple by scrape smears: a report of five cases. Diagn Cytopathol. 1993;9(3):291–295. doi: 10.1002/dc.2840090309. [DOI] [PubMed] [Google Scholar]
  63. Scheistrøen M., Tropé C., Kaern J., Pettersen E. O., Alfsen G. C., Nesland J. M. DNA ploidy and expression of p53 and C-erbB-2 in extramammary Paget's disease of the vulva. Gynecol Oncol. 1997 Jan;64(1):88–92. doi: 10.1006/gyno.1996.4517. [DOI] [PubMed] [Google Scholar]
  64. Shimizu S., Kobayashi H., Suchi T., Torii Y., Narita K., Aoki S. Extramammary Paget's disease arising in mature cystic teratoma of the ovary. Am J Surg Pathol. 1991 Oct;15(10):1002–1006. doi: 10.1097/00000478-199110000-00011. [DOI] [PubMed] [Google Scholar]
  65. Sitakalin C., Ackerman A. B. Mammary and extramammary Paget's disease. Am J Dermatopathol. 1985 Aug;7(4):335–340. doi: 10.1097/00000372-198508000-00004. [DOI] [PubMed] [Google Scholar]
  66. Smith K. J., Tuur S., Corvette D., Lupton G. P., Skelton H. G. Cytokeratin 7 staining in mammary and extramammary Paget's disease. Mod Pathol. 1997 Nov;10(11):1069–1074. [PubMed] [Google Scholar]
  67. Stacy D., Burrell M. O., Franklin E. W., 3rd Extramammary Paget's disease of the vulva and anus: use of intraoperative frozen-section margins. Am J Obstet Gynecol. 1986 Sep;155(3):519–523. doi: 10.1016/0002-9378(86)90270-x. [DOI] [PubMed] [Google Scholar]
  68. Stephenson T. J., Cotton D. W. Paget's disease in an epidermal cyst. Dermatologica. 1987;174(4):186–190. doi: 10.1159/000249171. [DOI] [PubMed] [Google Scholar]
  69. Swanson P. E., Mazoujian G., Mills S. E., Campbell R. J., Wick M. R. Immunoreactivity for estrogen receptor protein in sweat gland tumors. Am J Surg Pathol. 1991 Sep;15(9):835–841. doi: 10.1097/00000478-199109000-00003. [DOI] [PubMed] [Google Scholar]
  70. Takata M., Hatta N., Takehara K. Tumour cells of extramammary Paget's disease do not show either p53 mutation or allelic loss at several selected loci implicated in other cancers. Br J Cancer. 1997;76(7):904–908. doi: 10.1038/bjc.1997.482. [DOI] [PMC free article] [PubMed] [Google Scholar]
  71. Theaker J. M. Extramammary Paget's disease of the oral mucosa with in situ carcinoma of minor salivary gland ducts. Am J Surg Pathol. 1988 Nov;12(11):890–895. doi: 10.1097/00000478-198811000-00010. [DOI] [PubMed] [Google Scholar]
  72. Tsukada Y., Lopez R. G., Pickren J. W., Piver M. S., Barlow J. J. Paget's disease of the vulva: a clinicopathologic study of eight cases. Obstet Gynecol. 1975 Jan;45(1):73–78. [PubMed] [Google Scholar]
  73. WHORTON C. M., PATTERSON J. B. Carcinoma of Moll's glands with extramammary Paget's disease of the eyelid. Cancer. 1955 Sep-Oct;8(5):1009–1015. doi: 10.1002/1097-0142(1955)8:5<1009::aid-cncr2820080525>3.0.co;2-i. [DOI] [PubMed] [Google Scholar]
  74. Watanabe S., Ohnishi T., Takahashi H., Ishibashi Y. A comparative study of cytokeratin expression in Paget cells located at various sites. Cancer. 1993 Dec 1;72(11):3323–3330. doi: 10.1002/1097-0142(19931201)72:11<3323::aid-cncr2820721131>3.0.co;2-y. [DOI] [PubMed] [Google Scholar]
  75. Wienecke R., Eckert F., Kaudewitz P., de Viragh P. A., Heidl G., Volkenandt M. p53 protein in benign and malignant sweat gland tumors. Am J Dermatopathol. 1994 Apr;16(2):126–129. doi: 10.1097/00000372-199404000-00003. [DOI] [PubMed] [Google Scholar]
  76. Wolber R. A., Dupuis B. A., Wick M. R. Expression of c-erbB-2 oncoprotein in mammary and extramammary Paget's disease. Am J Clin Pathol. 1991 Aug;96(2):243–247. doi: 10.1093/ajcp/96.2.243. [DOI] [PubMed] [Google Scholar]
  77. Yim J. H., Wick M. R., Philpott G. W., Norton J. A., Doherty G. M. Underlying pathology in mammary Paget's disease. Ann Surg Oncol. 1997 Jun;4(4):287–292. doi: 10.1007/BF02303576. [DOI] [PubMed] [Google Scholar]
  78. van der Putte S. C. Anogenital "sweat" glands. Histology and pathology of a gland that may mimic mammary glands. Am J Dermatopathol. 1991 Dec;13(6):557–567. [PubMed] [Google Scholar]
  79. van der Putte S. C., Toonstra J., Hennipman A. Mammary Paget's disease confined to the areola and associated with multifocal Toker cell hyperplasia. Am J Dermatopathol. 1995 Oct;17(5):487–493. doi: 10.1097/00000372-199510000-00010. [DOI] [PubMed] [Google Scholar]
  80. van der Putte S. C., van Gorp L. H. Adenocarcinoma of the mammary-like glands of the vulva: a concept unifying sweat gland carcinoma of the vulva, carcinoma of supernumerary mammary glands and extramammary Paget's disease. J Cutan Pathol. 1994 Apr;21(2):157–163. doi: 10.1111/j.1600-0560.1994.tb00251.x. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Clinical Pathology are provided here courtesy of BMJ Publishing Group

RESOURCES