Extensive Extramammary Paget’s Disease With Underlying Perianal Adenocarcinoma: The Role of Neoadjuvant Radiation Treatment

Tran, Mai; Harvey, Jennifer A.

doi:10.7759/cureus.11966

Cited by 2 publications

(3 citation statements)

References 23 publications

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“…Adjuvant radiation therapy has also been recommended, especially in multifocal diseases, lymph node metastasis, positive surgical margins, and associated malignancies [ 9 ]. Hata et al [ 18 ] published the outcomes of eight patients with EMPD with lymph node metastasis treated with adjuvant radiation therapy.…”

Section: Discussionmentioning

confidence: 99%

“…In primary EMPD of the skin, invasion is usually only intraepidermal, and a relatively favorable prognosis can be expected; whereas, in secondary EMPD, due to the presence of invasive carcinoma of the neighboring organs, the prognosis is usually poor [8]. Tran et al reported that one of the treatment options is neoadjuvant radiation therapy with chemotherapy before surgery and then pelvic exenteration, which achieves a 3 Case Reports in Surgery complete response [9]. Katerji et al reported an HPV-related anorectal adenocarcinoma arising in a tubulovillous adenoma [10].…”

Section: Discussionmentioning

confidence: 99%

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Rare Anal Canal Cancer with Secondary Extramammary Paget’s Disease (Pagetoid Spread) Complicated by Squamous Cell Carcinoma of the Skin

Kusuhara

Ito

Matsuoka

et al. 2021

Case Reports in Surgery

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A 91-year-old man had a node and erythema in the anal area resistant to treatment. A biopsy of the node in the anus showed atypical cells developing as Paget’s disease, and staining revealed that the cells were CK7-positive, CK20-positive, and GCDFP15-negative. Therefore, tumor invasion with pagetoid spread (PS) from the anus to the skin was suspected, and the patient was referred to our department for a close examination and surgical treatment. Lower gastrointestinal endoscopy showed edematous, hemorrhagic mucosa in the anal canal, and he was diagnosed with adenocarcinoma via a biopsy. Additionally, redness and swelling with white moss were observed on the skin around the anus. Biopsy showed that Paget cells were diffusely present in the epithelium, and an image of squamous cell carcinoma directly under the epithelium was obtained. Taken together, the patient was diagnosed with the invasion of anal canal cancer with PS to the skin, and we performed laparoscopic abdominoperineal resection and skin carcinoma resection in the perineum. The histopathological analysis showed adenocarcinoma invading the external anal sphincter and subcutaneous adipose tissue in the vicinity of the pectinate line of the anal canal. Pagetoid spread of the adenocarcinoma was observed in the epidermis, and the open portion was slightly invaded up to the rectal mucosa. The anal skin region of the adenocarcinoma partially continued to the hair follicles, and it was complicated by squamous cell carcinoma invading the dermis. There are a few reports of anal canal cancer with PS, and the coexistence of adenocarcinoma and squamous cell carcinoma, as seen in the present case, is rare. We report our case together with relevant literature.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Rare Anal Canal Cancer with Secondary Extramammary Paget’s Disease (Pagetoid Spread) Complicated by Squamous Cell Carcinoma of the Skin

Kusuhara

Ito

Matsuoka

et al. 2021

Case Reports in Surgery

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“…If the disease is located, surgical resection is the most common treatment modality with curative intent. Radiotherapy and/or chemotherapy are generally opted for metastatic disease, although there are reports of its use as neoadjuvant or adjuvant therapy [ 12 ]. Radiotherapy can be used for symptom control or as an alternative to surgery in inoperable cases.…”

Section: Discussionmentioning

confidence: 99%

Perianal Paget Disease: Different Entities With the Same Name

Santos

Soares

Presa-Fernandes

et al. 2021

Cureus

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Extramammary Paget disease (EMPD) is a rare form of cancer that involves skin areas rich in apocrine glands. The common sites of occurrence include the vulva, perianal region, perineum, and axilla. Perianal Paget disease (PPD) is a subset of EMPD, which arises in the perianal skin. The disease commonly presents with a thickened plaque-like lesion with erythema or white scaly appearance. It is generally classified into two categories based on the origin of the tumor cells: (1) primary PPD if the tumor arises from intraepidermal cells and (2) secondary PPD if cancer originates from the underlying colorectal or urinary tract neoplasm. Due to its rarity, only a few sporadic case reports have been published in the literature, and treatment methods are yet to be standardized. In light of this, we report two PPD cases with different etiopathogenesis and staging: one involved only the perianal skin without regional or metastatic disease, and was not accompanied by visceral adenocarcinomas although there was a previous history of sigmoid adenocarcinoma; the other was probably secondary to an anal canal tumor spreading with disseminated disease involving the perianal and perineum area with bilateral inguinal, pelvic lymph node, and liver metastasis. The treatment plans and the outcomes of both cases were necessarily different from each other.

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Extensive Extramammary Paget’s Disease With Underlying Perianal Adenocarcinoma: The Role of Neoadjuvant Radiation Treatment

Cited by 2 publications

References 23 publications

Rare Anal Canal Cancer with Secondary Extramammary Paget’s Disease (Pagetoid Spread) Complicated by Squamous Cell Carcinoma of the Skin

Rare Anal Canal Cancer with Secondary Extramammary Paget’s Disease (Pagetoid Spread) Complicated by Squamous Cell Carcinoma of the Skin

Perianal Paget Disease: Different Entities With the Same Name

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