Extramammary Paget’s disease of penis and scrotum

Yang, Won Jae; Kim, Dong Suk; Im, Young Jae; Cho, Kang Su; Rha, Koon Ho; Cho, Nam Hoon; Choi, Young Deuk

doi:10.1016/j.urology.2004.12.010

Cited by 77 publications

(72 citation statements)

References 20 publications

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“…In general, wide local resection might be the best choice for EMPD because it offers the possibility of a cure [ 1 ] . The prevalence of local recurrence after wide local resection of penoscrotal EMPD has been reported to be 19.4 -27.3% of patients [ 3,4,7 ] . Early studies by our research team indicated that frozen section-guided wide local resection produces an acceptable prevalence of recurrence (16%) when treating penoscrotal EMPD.…”

Section: Discussionmentioning

confidence: 99%

“…Ensuring the depth as well as the extent of resection was an important feature of the operation. First, deep invasion of EMPD into subcutaneous tissues is possible [ 4,8 ] , and vertically inadequate resection could also lead to local recurrence. We controlled the surgical margin (horizontally and vertically), and the prevalence of local recurrence was much lower than that reported previously.…”

Section: Discussionmentioning

confidence: 99%

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Reconstruction with scrotal skin flaps after wide local resection of penoscrotal extramammary Paget's disease

Xiao

Zhang

et al. 2012

BJU International

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Study Type – Therapy (case series)Level of Evidence 4What's known on the subject? and What does the study add?Both the treatment and reconstruction after resection of penoscrotal extramammary Paget's disease (EMPD) are of concern among oncological urologists. Reconstruction of large skin defects after wide local resection of this disease remains challenging and skilled work.For the first time, by using scrotal skin flaps, we have introduced an effective and reliable procedure into the new area of reconstruction for penoscrotal EMPD in selected patients, with satisfactory functional and aesthetic results.OBJECTIVE To introduce an effective procedure for reconstruction of large skin defects after wide local resection of penoscrotal extramammary Paget's disease (EMPD) in selected patients using scrotal skin flaps without compromising oncological control. PATIENTS AND METHODS From January to June 2010 this procedure was carried out in five selected patients with penoscrotal EMPD who underwent wide local resection with subsequent reconstruction using scrotal skin flaps. Patient demographics, lesion characteristics, surgical margins and outcomes were evaluated. Skin defects covered 48–96 cm2 (median = 72 cm2). The median (range) duration of follow‐up was 24 (22–27) months. RESULTS Flaps survived with satisfactory functional and aesthetic results. All patients survived without local or systemic recurrence of tumour. CONCLUSIONS Wide local resection can provide cure in superficial penoscrotal EMPD. The described method using scrotal skin flaps seems to be a safe and effective procedure for the reconstruction of large defects.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Reconstruction with scrotal skin flaps after wide local resection of penoscrotal extramammary Paget's disease

Xiao

Zhang

et al. 2012

BJU International

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“…Most scientists believe that it is associated with malignancy of the large sweat glands, and is generally considered a special type of carcinoma in situ [7]. Generally, Paget’s disease of the scrotum is a relatively rare disease [8], but it appears to be much more common among the Chinese than among previously reported Western populations [6]. Paget’s disease of the scrotum is more common in older patients, with an average age at diagnosis of 64 years [8].…”

Section: Discussionmentioning

confidence: 99%

Frozen Section-Guided Wide Local Excision in the Treatment of Recurrent Scrotal Extramammary Paget’s Disease

Li²,

Xiang³

et al. 2012

Dermatology

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Background: A wide excision is generally accepted to be the standard modality of treatment for scrotal extramammary Paget’s disease (EMPD). The disease has a recurrence rate of about 10% and a second wide excision is still the chief treatment. We investigated the therapeutic methods for recurrent scrotal EMPD. Methods: We retrospectively studied the therapeutic methods and prognosis of 26 cases of recurrent EMPD. Seventy-two cases of primary scrotal EMPD served as controls. All of the cases were treated with frozen section-guided wide local excision. Results: There was no significant difference in the follow-up period of the recurrent cases before recurrence (p = 0.3228), local recurrence rate (p = 0.449), and total recurrence rate (p = 0.100) between the two groups, respectively. There is a favorable trend of worse mortality rate in the recurrence group (p = 0.056). The rate of inguinal lymph node metastasis was higher in the group with recurrent disease than in the control group (p = 0.017). Conclusion: Wide excision of the lesion still appears to be the most effective modality of treatment for recurrent scrotal Paget’s disease. Inguinal lymphadenectomy or sentinel lymph node biopsy should be offered to patients with primary lesions.

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“…Dermal invasion is seen in small proportion of cases and implies a poor prognosis 10 . Lack of E-cadherin expression and lymphovascular invasion have been shown to be important pathologic predictors of metastasis 34,35 . Immunohistochemically, the Paget cells frequently show positive reactivity to epithelial membrane antigen, cea, gross cystic disease fluid protein, and low molecular weight cytokeratins 36 .…”

Section: Pathologymentioning

confidence: 99%

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

et al. 2013

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The medical literature available to guide the management of empd is limited, particularly for metastatic disease. Another challenge is to differentiate metastatic empd from a concurrent invasive cancer. Here, we present our case series of 6 patients with empd of the penoscrotal region, our experience with systemic therapy, and a literature review for this rare malignancy. METHODSWe identified 6 cases of penoscrotal empd treated at The Ottawa Hospital from 2007 to 2012. All cases underwent pathology review. After research ethics board approval, clinical and demographic data, including age at presentation, presence of a second malignancy, management, and follow-up were collected from patient records. The literature was reviewed for clinical and pathologic features, treatment options, and outcomes. RESULTS 3

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Extramammary Paget’s disease of penis and scrotum

Cited by 77 publications

References 20 publications

Reconstruction with scrotal skin flaps after wide local resection of penoscrotal extramammary Paget's disease

Reconstruction with scrotal skin flaps after wide local resection of penoscrotal extramammary Paget's disease

Frozen Section-Guided Wide Local Excision in the Treatment of Recurrent Scrotal Extramammary Paget’s Disease

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

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