Mammary and Extramammary Paget’s Disease: A Study of 14 Cases and the Associated Therapeutic Difficulties

Extramammary Paget's Disease of the Perianal Region: A Review of the Literature Emphasizing Management

“…Patients with negative margins are clinically considered to have a lower recurrence rate; hence, intraoperative frozen section is a good way to identify the normal margin. Some authors advocated adequate use of intraoperative frozen section to determine the extent of excision, asserting its usefulness in decreasing recurrence rate . However, the effectiveness of intraoperative frozen sections in reducing recurrence rates remains controversial because some authors would not expect intraoperative frozen section analysis of margins to substantially reduce incidence of the microscopically positive margins on permanent sections …”

“…Some authors advocated adequate use of intraoperative frozen section to determine the extent of excision, asserting its usefulness in decreasing recurrence rate. 1,3,4,17 However, the effectiveness of intraoperative frozen sections in reducing recurrence rates remains controversial because some authors would not expect intraoperative frozen section analysis of margins to substantially reduce incidence of the microscopically positive margins on permanent sections. 18 Excision with wide margins may distort normal anatomy and lead to delayed wound healing, 19 A practical problem associated with this therapeutic modality is the difficulty of closing or reconstructing the defects resulting from surgery.…”

“…18 Excision with wide margins may distort normal anatomy and lead to delayed wound healing, 19 A practical problem associated with this therapeutic modality is the difficulty of closing or reconstructing the defects resulting from surgery. 17 Many reconstruction techniques using skin grafts or flaps have been reported to reconstruct the defects for cosmetic and functional preservation. 20 Fujii and colleagues recommend bilateral V-Y advancement posterior thigh fasciocutaneous flaps as one of the most effective techniques for managing large anogenital defects.…”

Extramammary Paget′s disease: Analysis of 17 Chinese cases

“…The mainstay of treatment is wide surgical excision on both the surface and deeply. [17][18][19] Nevertheless, the disease is notorious for its high recurrence rate, ranging between 12% and 58%, with an average of 33%. Mohs micrographic surgery is a surgical technique performed in cases with a high risk of recurrence.…”

Case for diagnosis

“…5 We can also point to radiotherapy, CO 2 or Nd:YAG lasertherapy, and topicals such as 5fluorouracil, imiquimod and bleomycin which may play a part in either the neoadjuvant or adjuvant treatment of the primary cancer or relapses. 6,7,8,9 …”