Management of secondary Paget’s disease of the vulva associated with transitional cell carcinoma

Kajtezovic, Sidika; Walker, Allison R.; Hjalmarsson, B.; Bell, S. G.; Everett, Elise; Wong, Cheung

doi:10.1007/s00432-022-04007-z

Cited by 2 publications

(3 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[3][4][5] CK7 and GATA3 also stain urothelial carcinoma and cannot be used to distinguish secondary involvement in the vulva. 6 In a subset of cases, p63 and uroplakin can be used to distinguish EMPD and urothelial carcinoma; however, p63 expression in non-neoplastic squamous epithelium and low sensitivity for uroplakin, respectively, limit their utility. 7 Melanoma in situ can be distinguished from EMPD based on an absence of keratins and GATA3, as well as the expression of traditional melanoma biomarkers.…”

Section: Discussionmentioning

confidence: 99%

“…EMPD traditionally expresses biomarkers similar to those seen in breast carcinoma, namely CK7, GATA3, mammaglobin and GCDFP, and is negative for melanoma biomarkers such as S100, SOX10 and Melan‐A 3–5 . CK7 and GATA3 also stain urothelial carcinoma and cannot be used to distinguish secondary involvement in the vulva 6 . In a subset of cases, p63 and uroplakin can be used to distinguish EMPD and urothelial carcinoma; however, p63 expression in non‐neoplastic squamous epithelium and low sensitivity for uroplakin, respectively, limit their utility 7 .…”

Section: Discussionmentioning

confidence: 99%

“…[3][4][5] Epithelial biomarker expression is not helpful for distinguishing secondary EMPD; however, uroplakin, CDX2 and CK20 may be helpful in a subset of cases. 3,6,7 Although p16 can be diffusely positive in EMPD, raising the possibility of an intra-epithelial squamous lesion, the staining is not typically the block-like pattern characteristic of human papilloma virus (HPV)-related lesions; additionally, EMPD has been shown to be HPV-negative by molecular studies. 8,9 Also, EMPD tumour cells are well known to be negative for melanoma markers, such as S100, HMB45 and Melan-A/Mart1.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

TRPS1 expression is sensitive and specific for primary extramammary Paget disease

2023

View full text Add to dashboard Cite

Aims: Extramammary Paget disease (EMPD) is an epithelial neoplasm that can occur at many sites, including the vulva and scrotum. EMPD is characterised by the presence of neoplastic cells, in single cells and clusters, that infiltrate all layers of nonneoplastic squamous epithelium. The differential diagnosis for EMPD includes melanoma in situ and secondary involvement of tumours from other sites, such as urothelial or cervical; pagetoid spread of tumor cells can also been seen at other sites, such as anorectal mucosa. The most frequently utilised biomarkers for confirming the diagnosis of EMPD include CK7 and GATA3; however, these biomarkers lack specificity. The purpose of this study was to evaluate TRPS1, a newly described breast biomarker, in pagetoid neoplasms of the vulva, scrotum and anorectum.Methods and results: Fifteen cases of primary EMPD of the vulva (two with associated invasive carcinoma) and four primary EMPD of the scrotum showed strong nuclear immunoreactivity for TRPS1. In contrast, five cases of vulvar melanoma in situ, one case of urothelial carcinoma with secondary pagetoid spread into the vulva and two anorectal adenocarcinomas with pagetoid spread into anal skin (one with associated invasive carcinoma) were negative for TRPS1. Additionally, weak nuclear TRPS1 staining was observed in nonneoplastic tissues (e.g. keratinocytes), but always with less intensity when compared to tumour cells. Conclusions: These results demonstrate that TRPS1 is a sensitive and specific biomarker for EMPD, and may be especially useful for excluding secondary involvement of the vulva by urothelial and anorectal carcinomas.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

TRPS1 expression is sensitive and specific for primary extramammary Paget disease

2023

View full text Add to dashboard Cite

show abstract

The current consensus for the diagnostic and treatment of extramammary Paget’s disease

Emelyanova¹,

Zikiryakhodzhaev

Saribekyan³

et al. 2023

Vestnik dermatologii i venerologii

View full text Add to dashboard Cite

Extramammary Paget's disease is a slow-growing cutaneous intraepithelial adenocarcinoma of the apocrine glands in the anogenital and axillary regions. The disease is extremely rare, affects predominantly postmenopausal women, and has nonspecific clinical caracteristics, so that it can take 2-10 years from the first clinical signs to diagnosis. The vulva and the perianal region are the most affected zones. Extramammary Pagets disease is clinically manifested as well-defined erythematous plaques with secondary changes, such as scaling, ulceration and even bleeding. Differential diagnosis is made between primary and secondary forms of Extramammary Pagets disease, candidiasis, contact dermatitis, Crohn's disease, eczema, erosive squamous lichen, purulent hydradenitis, Langerhans cell histiocytosis, sclerosing lichen, psoriasis, squamous cell carcinoma in situ, amelanocytic melanoma and mycosis fungoide. Treatment mainly includes the surgical component, as well as the use of photodynamic therapy, cytostatic agents, and, depending on the stage, systemic chemotherapy

show abstract

Management of secondary Paget’s disease of the vulva associated with transitional cell carcinoma

Cited by 2 publications

References 26 publications

TRPS1 expression is sensitive and specific for primary extramammary Paget disease

TRPS1 expression is sensitive and specific for primary extramammary Paget disease

The current consensus for the diagnostic and treatment of extramammary Paget’s disease

Contact Info

Product

Resources

About