An unusual presentation of mammary Paget’s disease with a 12-year duration and no palpable mass

Paget’s disease of the nipple is an unusual manifestation of breast cancer. Most cases of mammary Paget`s disease are associated with an invasive or in situ breast tumor, even with no mass observed in mammography imaging. Very rarely does Paget’s disease occur in the absence of any underlying neoplasia .Herein, we report an 82-year-old woman with an unusual presentation of mammary Paget’s disease with a 12-year duration, and no palpable mass, density or calcification in imaging assessments. Immunohistochemistry showed that the tumor cells stained positive for cytokeratin-7, and Her-2-neu, yet negative for S-100, HMB-45, CEA, and P63. Skin biopsy and immunohistochemistry findings corresponded with Paget’s disease.