Skip to main content
SpringerLink
Log in

Reconstruction with bilateral gluteus maximus myocutaneous rotation flap after wide local excision for perianal extramammary Paget's disease

Report of two cases

  • Case Reports
  • Published:
Diseases of the Colon & Rectum

Abstract

PURPOSE: Extramammary Paget's disease is a rare dermatosis. Wide local excision is recommended in patients with perianal extramammary Paget's disease. After wide local excision, it is necessary to do reconstruction, with preservation of bowel function. We present here two cases of perianal Paget's disease, in which the patients were treated by reconstruction with bilateral gluteus maximus myocutaneous rotation flap after wide local excision. PATIENTS AND METHODS: A 55-year-old woman and 58-year-old man were admitted with anal pain and bleeding. Histologic examination of the perianal lesion revealed the presence of typical Paget's cells, and no underlying carcinoma and no distant metastasis was detected in either patient. Wide local excision, including the rectal mucosa, was performed, with reference to intraoperative frozen sections. Surgical defect was overlapped with bilateral gluteus maximus myocutaneous rotation flap, and the anus was reconstructed. RESULTS: Postoperative bowel function and quality of life were well preserved, and flaps healed satisfactorily. Patients have had no recurrence and have been able to return to work. CONCLUSION: Bilateral gluteus maximus rotation flap may be useful after wide local excision of perianal extramammary Paget's disease without underlying invasive carcinoma.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Paget J. On disease of the mammary areola preceding cancer of the mammary gland. St Bartholomew Hosp Res London 1874;10:87–9.

    Google Scholar 

  2. Beck DE, Fazio VW. Perianal Paget's disease. Dis Colon Rectum 1987;30:263–6.

    PubMed  Google Scholar 

  3. Jensen SL, Sjolin KE, Shokouh-Amiri MH, Hagen K, Harling H. Paget's disease of the anal margin. Br J Surg 1988;75:1089–92.

    PubMed  Google Scholar 

  4. Tjandra J. Perianal Paget's disease: report of three cases. Dis Colon Rectum 1988;31:462–6.

    PubMed  Google Scholar 

  5. Berardi RS, Lee S, Chen HP. Perianal extramammary Paget's disease. Surg Gynecol Obstet 1988;167:359–65.

    PubMed  Google Scholar 

  6. Strauss RJ, Levon LR, Tenenbaum N. Bowen's disease and Paget's disease. In: Fazio VW, ed. Current therapy in colon and rectal surgery. Toronto: BC Decker, 1990:59–62.

    Google Scholar 

  7. Thirlby RC, Hammer ChJ Jr, Galagan KA, Travaglini JJ, Picozzi VJ Jr. Perianal Paget's disease: successful treatment with combined chemoradiotherapy. Report of case. Dis Colon Rectum 1990;33:150–2.

    PubMed  Google Scholar 

  8. Herzog U, Flüe M, Roche R, Curschellas E. Perianal extramammary Paget's disease: report of two cases. Eur J Surg Oncol 1993;19:469–73.

    PubMed  Google Scholar 

  9. Fligiel Z, Kaneko M. Extramammary Paget's disease of the external ear canal in association with ceruminous gland carcinoma: a case report. Cancer 1975;36:1072–6.

    PubMed  Google Scholar 

  10. Worthon GM, Patterson LB. Carcinoma of Moll's glands with extramammary Paget's disease of the eyelid. Cancer 1955;8:1009–15.

    PubMed  Google Scholar 

  11. Pitman GH, MacCarthy JG, Perzin KH, Herter FP. Extramammary Paget's disease. Plast Reconstr Surg 1982;69:238–44.

    PubMed  Google Scholar 

  12. Weiber H, Ekelund G, Linström C. Perianal Paget's disease. Acta Chir Scand 1982;153:687–90.

    Google Scholar 

  13. Grodsky L. Extramammary Paget's disease of the perianal region. Dis Colon Rectum 1960;3:502–10.

    PubMed  Google Scholar 

  14. Stacy D, Burrell MO, Franklin EW. Extramammary Paget's disease of the vulva and anus: use of intraoperative frozen-sections. Am J Obstet Gynecol 1986;155:519–23.

    PubMed  Google Scholar 

  15. Besa P, Rich TA, Delclos L, Edwards CL, Ota DM, Wharton JT. Extramammary Paget's disease of the perineal skin: role of radiotherapy. Int J Radiot Oncol Biol Phys 1992;24:73–8.

    Google Scholar 

  16. Voigt H, Bassermann R, Nathrath W. Cytoreductive combination chemotherapy for regionally advanced unresectable extramammary Paget carcinoma. Cancer 1992;70:704–8.

    PubMed  Google Scholar 

  17. Scheflan M, Nahai F, Bostwick J. Gluteus maximus island musculocutaneous flap for closure of sacral and ischial ulcers. Plast Reconstr Surg 1981;68:533–8.

    PubMed  Google Scholar 

  18. Hurwitz DJ, Swartz WM, Mathes SJ. The gluteal thigh flap: a reliable, sensate flap for the closure of buttock and perineal wounds. Plast Reconstr Surg 1981;68:521–32.

    PubMed  Google Scholar 

  19. Rajacic N, Gang RK, Dashti H, Behbehani A. Treatment of ischial pressure sores with an inferior gluteus maximus musculocutaneous island flap: an analysis of 31 flaps. Br J Plast Surg 1994;47:431–4.

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Second Department of Surgery, Wakayama Medical School, 27-Shichibancho, 640, Wakayama, Japan

    Koichi Murakami M.D., Hiroshi Tanimura M.D., Kiwao Ishimoto M.D., Hiroki Yamaue M.D., Naohisa Yamade M.D. & Tetsuya Shimamoto M.D.

Authors
  1. Koichi Murakami M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Hiroshi Tanimura M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Kiwao Ishimoto M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Hiroki Yamaue M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Naohisa Yamade M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Tetsuya Shimamoto M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

About this article

Cite this article

Murakami, K., Tanimura, H., Ishimoto, K. et al. Reconstruction with bilateral gluteus maximus myocutaneous rotation flap after wide local excision for perianal extramammary Paget's disease. Dis Colon Rectum 39, 227–231 (1996). https://doi.org/10.1007/BF02068081

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02068081

Key words

Search

Navigation