Usefulness of Three-dimensional Dynamic MRI in the Diagnosis of Paget's Disease. A Case Report.

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  • 陥没乳頭に出現したＰａｇｅｔ病の乳管内進展巣の評価に３Ｄ　ｄｙｎａｍｉｃ　ＭＲＩが有用であった１例

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Abstract

A 42-year-old woman was admitted to our hospital because of an eczematous lesion on an inverted right nipple. She was diagnosed with Paget's disease of the breast by clinical and cytological examina-tions. A palpable mass was not found in her right breast. A mammography showed only microcalcification within the nipple, and an ultrasonography showed no abnormal findings, such as a tumor shadow or duct ectasia. She was then examined using three-dimensional dynamic MRI (3D MRI) to assess the intramammary extent of Paget's disease as part of a pre-surgical examination. The 3D MRI findings showed a wide area of early enhancement, suggesting remarkable intraductal extension. We performed a sentinel lymphnode biopsy and, since sentinel lymphnode metastasis was not observed, a mastectomy without axillar disection. Histopathological findings revealed remarkable intraductal extension in the surgical specimen consistent with the early enhancement area on the 3D MRI findings. This demonstrates that 3D MRI is useful for the assessment of intraductal involvement in Paget's disease of the breast.

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