Extramammary Paget’s Disease: 20 Years of Experience in Chinese Population

Abstract

Background. To examine the results of treatment of Extramammary Paget's disease (EMPD) in ethnic Chinese. Method. Between 1990 and 2010, patients treated for EMPD were reviewed. Data were analyzed retrospectively. Results. Forty-eight patients were treated by surgical resection. Local recurrence rate was 14.6%. The postresection defects were repaired by primary closure (8.3%), partial thickness skin graft (72.9%), or local/regional flaps (18.8%). Dermal invasion was found in 9 patients (18.8%). Seven patients (14.6%) developed regional lymph node metastasis (concurrent with surgery, n = 1; subsequent to surgery, n = 6), and 3 patients (6.3%) had systemic metastasis after surgery. The presence of dermal invasion was associated with significantly higher incidence of regional lymph nodes and systemic metastasis. The incidence of associated internal malignancy was 8.3%. Conclusion. The mainstay of treatment for EMPD is surgery. Pathological dermal invasion increases the chance of regional lymph node as well as systemic metastasis. The association with internal malignancy warrants preoperative endoscopic examination in all patients.

5-aminolevulinic acid (5-ALA) fluorescence-guided Mohs surgery resection of penile-scrotal extramammary Paget's disease

“…Therefore, various trials, such as intraoperative frozen sections or Mohs micrographic surgery (MMS), were performed to achieve tumor-free margins. However, frozen sections have a false-negative rate of 10.4%, up to as high as 40%, and is known to have no improvement in disease outcome (15,16). MMS may lower local recurrence rate (17)(18)(19)(20) but is timeconsuming and requires additional faculty for use.…”

Perianal Paget’s Disease with synchronous adenocarcinoma: An unusual diagnosis

“…[2,7] Surgical methods of treatment are still the mainstay, although other non-surgical modalities have been described (radiotherapy, chemo-radiotherapy, photodynamic therapy, imiquimod 5% cream). [8,9] Local recurrence is high (31%-61%), so long-term follow-up must be guaranteed. [10] 4.…”

Management of Penoscrotal Extramammary Paget Disease: Case Series and Review of the Literature

“…Because of their benign appearance, these lesions are often neglected for several years before being presented for medical attention. The diagnosis can be challenging, and initial medical management commonly includes antifungal creams or topical steroids before a biopsy is done 8,9 . The differential diagnosis includes superficial spreading melanoma, Bowen disease, neuroendocrine carcinoma, mycosis fungoides, psoriasis, leukoplakia, eczema, fungal infection 10 , or intra-epidermal spread of visceral carcinoma (pagetoid effect) 11 .…”