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Diseases of the Colon & Rectum

, Volume 51, Issue 12, pp 1842–1845 | Cite as

Perianal Paget’s Disease Treated with Wide Excision and Gluteal Skin Flap Reconstruction: Report of a Case and Review of the Literature

  • Wolfgang B. GaertnerEmail author
  • Gonzalo F. Hagerman
  • Stanley M. Goldberg
  • Charles O. FinneIII
Multimedia Article

Abstract

Background

Paget’s disease of the anus is a rare perianal disorder. The condition is often associated with underlying invasive carcinoma and the prognosis is poor when underlying adenocarcinoma is present.

Methods

We report the case of a 72-year-old woman suffering from a two-year history of perianal itching, bleeding, and irritation. Perianal Paget’s disease was confirmed by histopathologic demonstration of Paget’s cells from a biopsy. Synchronous malignancy and metastasis were excluded.

Results

A first-stage operation consisted of a wide excisional biopsy with frozen section margin assessment. Permanent sections confirmed absence of invasive carcinoma and clear margins. Four days after wide excision, bilateral gluteal skin flap reconstruction was performed with a temporary diverting colostomy. No adjuvant therapy was necessary, and after one-year follow-up, the patient remains disease free.

Conclusion

Perianal Paget’s disease continues to pose problems in diagnosis and treatment. Our case report of perianal Paget’s disease shows one method of management for advanced non invasive disease.

Key words

Perianal Paget’s disease Treatment Surgery 

Supplementary material

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(MPG 169 KB)

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Copyright information

© The American Society of Colon and Rectal Surgeons 2008

Authors and Affiliations

  • Wolfgang B. Gaertner
    • 1
    Email author
  • Gonzalo F. Hagerman
    • 1
  • Stanley M. Goldberg
    • 1
  • Charles O. FinneIII
    • 1
  1. 1.Division of Colon and Rectal Surgery, Department of SurgeryUniversity of MinnesotaMinneapolisUSA

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