Doença de Paget invasiva da vulva e região perianal: relato de caso

Trindade, Etelvino de Souza; Polcheira, Paulo Arlindo; Basílio, Dúnya Bachour; Rocha, Zali Neves da; Júnior, José Lopes Rocha; Primo, Guttenberg Rodrigues Pereira

doi:10.1590/s0100-72032004000400011

Cited by 4 publications

(4 citation statements)

References 7 publications

(13 reference statements)

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“…Histopathology defines the diagnosis, staging, and follow-up of EMPD. 8 Surgery is the initial treatment of choice for perianal disease. For premalignant lesions, wide local excision with or without flaps is indicated, while abdominoperineal resection is indicated for invasive disease.…”

Section: Discussionmentioning

confidence: 99%

Perianal Paget's disease

Cassol

Pastorello

Oliveira

et al. 2019

Journal of Coloproctology

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Paget's disease most commonly affects the breast. Extramammary involvement is rare, and the most commonly affected sites are the vulva, anus, perianal region, and axilla. The disease may progress to invasive adenocarcinoma or synchronous cancers. Due to the lack of distinctive features and nonspecific presenting symptoms, Paget's disease may be misdiagnosed as other conditions, thus delaying the correct diagnosis. We report a case of extramammary Paget's disease in the perianal region that initially presented as an irregular, circumferential, scaling lesion with eczematous eruptions. Immunology and immunohistochemistry confirmed the diagnosis. Although surgery is the standard treatment, the patient opted for pelvic radiotherapy associated with radiosensitizing chemotherapy.

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Section: Discussionmentioning

confidence: 99%

Perianal Paget's disease

Cassol

Pastorello

Oliveira

et al. 2019

Journal of Coloproctology

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“…Embora as lesões histológicas observadas nos caprinos biopsiados também fossem de distribuição algumas vezes extensiva, semelhante ao que se vê em casos de ceratose actínica do tipo Bowenoid (CCE in situ), de doença de Bowen (Elder et al 2004), de doença de Paget extramamária (Trindade et al 2004), bem como em "spread" carcinoma e em alguns melanomas, nos quais se observa um crescimento linear e pouca ou nenhuma infiltração para derme, observou-se crescimento infiltrativo em direção à derme mais profunda, achado que consolida o diagnóstico de CCE.…”

Section: Discussionunclassified

“…Existem numerosos relatos de doença de Paget vulvar (DPV) em humanos, dos quais em apenas alguns pacientes foi constatada invasão estromal (Trindade et al 2004). Não encontramos relatos dessa enfermidade na vulva de ruminantes e nem o material por nós examinado revelou as típicas células de Paget.…”

Section: Discussionunclassified

Carcinoma de células escamosas perineal em cabras no Pará

et al. 2009

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Pesq. Vet. Bras. 29(5): 421-427, maio 2009 RESUMO.-Descreve-se a ocorrência de carcinoma de células escamosas (CCE) bem diferenciado em caprinos de duas propriedades no Estado do Pará. Foram observadas a prevalência, a correlação com a pigmentação da região perineal e as características macro e microscópi-ca das lesões. As lesões consistiram em tumores no períneo, com grau de desenvolvimento, diâmetro e forma variados. Em uma propriedade no município de Viseu, dos 347 caprinos, 20 apresentaram CCE (5,8%). A neoplasia só foi observada em animais com a região perineal despigmentada. Em outra propriedade, no município de Garrafão do Norte, descreve-se a ocorrência de três casos em um rebanho de 400 caprinos (0,75%). A elevada ocorrência deste tumor deve-se, provavelmente, à despigmentação do períneo e à cauda curta e elevada das cabras, que expõe a região perineal à alta incidência de radiação ultravioleta naquela região. TERMOS DE INDEXAÇÃO: Carcinoma epidermóide, caprinos, patologia. INTRODUÇÃONos últimos anos, a caprinocultura vem crescendo no Pará, Estado que possui o maior rebanho da Região Norte, embora alguns fatores desfavoráveis para a espécie como altos índices pluviométricos, alta umidade relativa do ar e manejo sanitário deficiente, predisponham esses animais a enfermidades diversas. Como se trata de região equatorial, lesões de pele devidas à elevada incidência de raios ultravioleta adquirem destaque.De fato, neoplasias da pele e anexos são comuns em animais que vivem em países de clima tropical como o Brasil, em especial pela exposição crônica dos animais à radiação ultravioleta (Goldschmidt & Hendrick 2002 diomedes@ufpa.br Squamous cell carcinoma in goats of two farms in the State of Pará is described. Prevalence, correlation with the pigmentation of the perineal area and macro and microscopic characteristics of the lesions were studied. The tumors on the perineum were of varied development degrees, diameters and forms. On one farm, in the county of Viseu, from a total of 347 goats, 20 presented the neoplasia (5.8%). On the second farm, in the county of Garrafão do Norte, three cases of squamous cell carcinoma in a herd of 400 goats (0.75%) were observed. The tumor was only observed in animals in which the perineal area was despigmented. The high incidence of this tumor appears to be due to lack of pigmentation at the períneo and the high and short tail of the goats, that exposes the area to intense ultraviolet radiation in the tropics.INDEX TERMS: Squamous cell carcinoma, goats, pathology.

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“…In Brazil, Tanaka et al [ 5 ] reported 14 cases of EMPD, four of which involved women with disease in the vulvar, groin or perianal areas. Trindade et al [ 6 ] reported a primary Brazilian PPD patient, which presented erythematous, itching and little bleeding. The staging tests were normal, without evidence of metastasis.…”

Section: Introductionmentioning

confidence: 99%

Rare perianal extramammary Paget disease successfully treated using topical Imiquimod therapy

et al. 2018

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BackgroundPerianal Paget’s disease (PPD) is a rare intraepithelial adenocarcinoma of the anal margin. Primary PPD likely represents intra-epithelial neoplasm from an apocrine source, whereas secondary disease may represent “pagetoid” spread from an anorectal malignancy.Case presentationHistologic CDX-2 and CK20 are hallmark markers for colorectal-derived Paget’s cells. Interestingly, our primary PPD patient presented both positive and no internal malignancy was identified. In addition, a negative CK7 marker was observed in our case in contrast with previously reported. Surgical excision is the standard treatment; however, previous studies have demonstrated good response with Imiquimod 5% cream in patients with vulval extramammary Paget disease (EMPD). The efficiency of Imiquimod treatment for PPD has not been well described. Our PPD patient was successfully treated using Imiquimod 5% cream.ConclusionsThis study describes a primary cutaneous PPD patient CDX-2+/CK20+/CK7- without invasion of the dermis and no associated colorectal carcinoma effectively treated using topical Imiquimod therapy, suggesting that Imiquimod might potentially be considered as a first-line treatment for PPD.

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Doença de Paget invasiva da vulva e região perianal: relato de caso

Cited by 4 publications

References 7 publications

Perianal Paget's disease

Perianal Paget's disease

Carcinoma de células escamosas perineal em cabras no Pará

Rare perianal extramammary Paget disease successfully treated using topical Imiquimod therapy

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