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Zhao C, Zhang G, Li Y, Zhang C, Yang S, Li H. Concurrent extramammary Paget's disease involving the genitalia and axilla: Case report and literature review. Australas J Dermatol 2022; 63:e226-e230. [PMID: 35622937 DOI: 10.1111/ajd.13883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 05/15/2022] [Indexed: 11/30/2022]
Abstract
Concurrent multiple primary extramammary Paget's disease (EMPD) is rare. Herein, we present two Chinese cases of concurrent primary EMPD involving both the genitalia and the axilla, and they also had a history of other malignancy. We also summarise the cases of multiple primary EMPD previously described in literature. Careful examination of all apocrine sweat gland-bearing sites and additional internal malignancies is recommended for patients with EMPD.
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Affiliation(s)
- Chunxia Zhao
- Department of Dermatology and Venerology, Peking University First Hospital, Beijing, China.,National Clinical Research Center For Skin and Immune Diseases, Beijing, China.,Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, Beijing, China.,NMPA Key Laboratory for Quality Control and Evaluation of Cosmetics, Beijing, China
| | - Guohong Zhang
- Department of Dermatology and Venerology, Peking University First Hospital, Beijing, China.,National Clinical Research Center For Skin and Immune Diseases, Beijing, China.,Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, Beijing, China.,NMPA Key Laboratory for Quality Control and Evaluation of Cosmetics, Beijing, China
| | - Yurong Li
- Department of Dermatology and Venerology, Peking University First Hospital, Beijing, China.,National Clinical Research Center For Skin and Immune Diseases, Beijing, China.,Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, Beijing, China.,NMPA Key Laboratory for Quality Control and Evaluation of Cosmetics, Beijing, China
| | - Chong Zhang
- Department of Dermatology and Venerology, Peking University First Hospital, Beijing, China.,National Clinical Research Center For Skin and Immune Diseases, Beijing, China.,Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, Beijing, China.,NMPA Key Laboratory for Quality Control and Evaluation of Cosmetics, Beijing, China
| | - Shuxia Yang
- Department of Dermatology and Venerology, Peking University First Hospital, Beijing, China.,National Clinical Research Center For Skin and Immune Diseases, Beijing, China.,Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, Beijing, China.,NMPA Key Laboratory for Quality Control and Evaluation of Cosmetics, Beijing, China
| | - Hang Li
- Department of Dermatology and Venerology, Peking University First Hospital, Beijing, China.,National Clinical Research Center For Skin and Immune Diseases, Beijing, China.,Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, Beijing, China.,NMPA Key Laboratory for Quality Control and Evaluation of Cosmetics, Beijing, China
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Dauendorffer JN, Herms F, Baroudjian B, Basset-Seguin N, Cavelier-Balloy B, Fouéré S, Bagot M, Lebbé C. Penoscrotal Paget's disease. Ann Dermatol Venereol 2021; 148:71-76. [PMID: 33461789 DOI: 10.1016/j.annder.2020.08.051] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 05/12/2020] [Accepted: 08/31/2020] [Indexed: 10/22/2022]
Abstract
Paget's disease (PD) denotes an initially intra-epidermal adenocarcinoma that can later invade the dermis and metastasise. Among the extramammary forms of PD (EMPD), penoscrotal presentations are rarer than the vulvar and perianal forms. Once diagnosis has been confirmed by histopathological examination, a search for associated neoplasia must be conducted, although penoscrotal EMPD is less frequently associated with underlying neoplasia than mammary PD (MPD). The associated cancer most often involves a neighbouring organ, with prostate cancer being the most common, or in some cases consists of underlying cutaneous adnexal tumours. First-line therapy consists of surgical excision. Alternatives to surgery (imiquimod, CO2 laser vaporisation, dynamic phototherapy) may be considered in certain cases.
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Affiliation(s)
| | - F Herms
- Department of Dermatology, Hôpital Saint-Louis, Paris, France
| | - B Baroudjian
- Department of Dermatology, Hôpital Saint-Louis, Paris, France
| | - N Basset-Seguin
- Department of Dermatology, Hôpital Saint-Louis, Paris, France
| | | | - S Fouéré
- Department of Dermatology, Hôpital Saint-Louis, Paris, France
| | - M Bagot
- Department of Dermatology, Hôpital Saint-Louis, Paris, France
| | - C Lebbé
- Department of Dermatology, Hôpital Saint-Louis, Paris, France
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Rao D, Zhu H, Yu K, Yu H, Xie L. Two cases of Paget's disease of scrotum in biological brothers. Ther Clin Risk Manag 2015; 11:885-7. [PMID: 26064056 PMCID: PMC4455842 DOI: 10.2147/tcrm.s80431] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
This article reports two cases of scrotum Paget's disease in two biological brothers who were admitted and treated in our hospital in 2013. They are very rare cases. The present article discusses the potential management of Paget's disease and the importance of long-term follow-up.
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Affiliation(s)
- Dapang Rao
- Department of Urology, First affiliated Hospital, Medical College, Zhejiang University, Hangzhou, People's Republic of China
| | - Haibo Zhu
- Department of Urology, second affiliated Hospital of Wenzhou Medical University, Wenzhou, People's Republic of China
| | - Kaiyuan Yu
- Department of Urology, second affiliated Hospital of Wenzhou Medical University, Wenzhou, People's Republic of China
| | - Haifeng Yu
- Department of Urology, second affiliated Hospital of Wenzhou Medical University, Wenzhou, People's Republic of China
| | - Liping Xie
- Department of Urology, First affiliated Hospital, Medical College, Zhejiang University, Hangzhou, People's Republic of China
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Feng CC, Wang LJ, Zhou ZW, Ding Q, Fang ZJ, Xia GW, Jiang HW, Xu G, Wen H. Positive KI67 and periodic acid-schiff mandates wider range of excision in scrotal extramammary Paget's disease. Dermatol Surg 2013; 39:381-6. [PMID: 23279036 DOI: 10.1111/dsu.12080] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Extramammary Paget's disease (EMPD) of the scrotum is a rare disease that requires surgical excision. A positive margin is related to recurrence and poorer prognosis. We aimed to investigate the expression of Ki67 and periodic acid-Schiff (PAS) in a biopsy sample and to evaluate their predictive value in true margin status. METHODS Sixty-four patients with noninvasive scrotal EMPD were included. Immunohistochemical staining of Ki67 and PAS was reviewed and compared statistically with the margin status of intraoperative frozen section examination (FSE). RESULTS Seventeen of 64 patients had a positive margin discovered at the first FSE. Expression of Ki67 was not significantly different between positive and negative margin status (p = .16). Expression of PAS was higher in samples with positive margins (p = .05). The incidence of positive margins was significantly higher in the double-positive group than in the double-negative group (p = .03). CONCLUSION Positive expression of both factors in a biopsy sample requires wider excision to ensure negative margins.
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Affiliation(s)
- Chen-Chen Feng
- Department of Urology, Huashan Hospital, Fudan University, Shanghai, China
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Li B, Li L, Wang X, Xu K, Fang Z, Ding Q. Frozen section-guided wide local excision in the treatment of recurrent scrotal extramammary Paget's disease. Dermatology 2012; 224:231-5. [PMID: 22517355 DOI: 10.1159/000337542] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2011] [Accepted: 02/14/2012] [Indexed: 12/27/2022] Open
Abstract
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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Affiliation(s)
- Bingkun Li
- Department of Urology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
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