Skip to main content

Advertisement

SpringerLink
Log in

Extramammary Paget’s Disease: Isolated Localization on the Groin—Wide Local Excision With Immediate Reconstruction

  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Extramammary Paget’s disease is a rare cutaneous malignancy, which occurring frequently in the elderly and affecting primarily the genital, perianal, and axillary regions. Unfortunately, surgical and ablative treatment modalities for extramammary Paget’s disease have a high recurrence rate and are often associated with significant morbidity.

Methods

We present a case of a 51-year-old Caucasian man with Paget’s disease of the right groin. The isolated localization of Paget’s disease in the groin is extremely rare. Wide local excision of the tumor is currently the standard of care treatment. All publications found in the literature reporting this rare entity were reviewed for the purpose of further delineating a treatment regimen for this rare pathology.

Results

Six years after surgery, the patient remains disease free with a very acceptable aesthetic result. Currently, only 11 cases of Paget’s disease have been reported with an isolated localization to the groin.

Conclusions

Paget’s disease of the groin has an extremely low incidence. Various treatments are described in the literature, early wide local excision may be the treatment of choice.

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

FIG. 1.
FIG. 2.
FIG. 3.
FIG. 4.
FIG. 5.
FIG. 6.

Similar content being viewed by others

References

  1. Crocker HR. Paget’s disease, affecting the scrotum and penis. Trans Pathol Soc (Lond) 1889;40:187–91

    Google Scholar 

  2. Balducci L, Crawford ED, Smith GF, Lambuth B, McGehee R, Hardy C. Extramammary Paget’s disease: an annotated review. Cancer Invest 1988;6:293–303

    Article  PubMed  CAS  Google Scholar 

  3. Yugueros P, Keeney GL, Bite U. Paget’s disease of the groin: report of seven cases. Plast Reconstr Surg 1997;100:336–9

    Article  PubMed  CAS  Google Scholar 

  4. Zampogna JC, Flowers FP, Roth WI, Hassenein AM. Treatment of primary limited cutaneous extramammary Paget’s disease with topical imiquimod monotherapy: two case reports. J Am Acad Dermatol 2002;47(4 Suppl):S229–35

    Article  PubMed  Google Scholar 

  5. Zollo JD, Zeitouni NC. The Roswell Park Cancer Institute experience with extramammary Paget’s disease. Br J Dermatol 2000;142:59–65

    Article  PubMed  CAS  Google Scholar 

  6. Pierie JP, Choudry U, Muzikansky A, Finkelstein D, Ott M Prognosis and management of extramammary Paget's disease and the associationwith secondary malignancies. J Am Coll Surg 2003;196(1) :45–50

    Article  PubMed  Google Scholar 

  7. Coldiron BM, Goldsmith BA, Robinson JK. Surgical treatment of extramammary Paget’s disease. A report of six cases and a reexamination of Mohs micrographic surgery compared with conventional surgical excision. Cancer 1991;67:933–8

    Article  PubMed  CAS  Google Scholar 

  8. Ojeda VJ, Heenan PJ, Watson SH. Paget’s disease of the groin associated with adenocarcinoma of the urinary bladder. J Cutan Pathol 1987;14:227–31

    Article  PubMed  CAS  Google Scholar 

  9. Fu M, Gao S, Wang P. 19 cases of Paget’s disease. Zhonghua Wai Ke Za Zhi 1999;37:429–31

    PubMed  CAS  Google Scholar 

  10. Pitman GH, McCarthy JG, Perzin KH, Herter FP. Extramammary Paget’s disease. Plast Reconstr Surg 1982;69:238–44

    Article  PubMed  CAS  Google Scholar 

  11. Burrows NP, Jones DH, Hudson PM, Pye RJ. Treatment of extramammary Paget’s disease by radiotherapy. Br J Dermatol 1995;132:970–2

    Article  PubMed  CAS  Google Scholar 

  12. Shieh S, Dee AS, Cheney RT, Frawley NP, Zeitouni NC, Oseroff AR. Photodynamic therapy for the treatment of extramammary Paget’s disease. Br J Dermatol 2002;146:1000–5

    Article  PubMed  CAS  Google Scholar 

  13. Van Hamme C, Marot L, Dachelet C, Dumont M, Salamon E, Lachapelle JM. Paget’s extramammary disease of the axillae and perineum. Ann Dermatol Venereol 2002;129:717–9

    PubMed  Google Scholar 

  14. Chanda JJ. Extramammary Paget’s disease. Prognosis and relationship to internal malignancy. J Am Acad Dermatol 1985;13:1009–14

    Article  PubMed  CAS  Google Scholar 

  15. Hartley EL, Nambisan RN, Rao U, Karakousis CP. Extramammary Paget disease of the inguinoscrotal area. N Y State J Med 1988;88:546–8

    PubMed  CAS  Google Scholar 

  16. Marchesa P, Fazio VW, Oliart S, Goldblum JR, Lavery IC, Milsom JW. Long-term outcome of patients with perianal Paget’s disease. Ann Surg Oncol 1997;4:475–80

    Article  PubMed  CAS  Google Scholar 

  17. Chandawarkar RY, Ricchuiti D, Amjad I, Marsico RE, Wells MD. Extramammary Paget’s disease of the perineum: avoiding pitfalls in diagnosis and management. Can J Plast Surg 2003;11:205–8

    Google Scholar 

  18. Tsutsumida A, Yamamoto Y, Minakawa H, Yoshida T, Kokubu I, Sugihara T. Indications for lymph node dissection in the treatment of extramammary Paget’s disease. Dermatol Surg 2003;29:21–4

    Article  PubMed  Google Scholar 

  19. Park S, Grossfeld GD, McAninch JW, Santucci R. Extramammary Paget's disease of the penis and scrotum: excision, reconstruction and evaluation of occult malignancy. J Urol 2001; 166(6):2112–2116; discussion 2117

    Google Scholar 

  20. Yang WJ, Kim DS, Im YJ, Cho KS, Rha KH, Cho NH, Choi YD. Extramammary Paget's disease of penis and scrotum. Urology 2005; 65(5):972–975

    Google Scholar 

  21. Dufourmentel CL. La fermeture des pertes des substance cutanée limitées. Le “lambeau de rotation en L pour losange,” dit ‘LLL.’ Ann Chir Plast Esthet 1962;7:61–6

    Google Scholar 

  22. Servant JM, Dufourmentel CL. (1984) Treatment of facial lesions. In: Goldwyn, eds. The Unfavorable Result in Plastic Surgery. Boston: Brown & Co, 1(19):348–50

  23. Coit DG, Peters M, Brennan MF. A prospective randomized trial of perioperative cefazolin treatment in axillary and groin dissection. Arch Surg 1991;126:1366–71

    PubMed  CAS  Google Scholar 

  24. Tonuchi H, Ohmori Y, Kobayashi M, et al. Operative morbidity associated with groin dissections. Surg Today 2004;34:413–8

    Article  Google Scholar 

Download references

Acknowledgments

The authors thank Professor A. Mylonas, MD, Ph.D for gastrointestinal investigation and K. Syllas, MD, Pathologist for the microphotograph.

Author information

Authors and Affiliations

  1. Division of Skin Oncologic Surgery–Plastic Surgery, First Department of Dermatology, Aristotle University of Thessaloniki, Thessaloniki, Greece

    Alexander Dionyssopoulos MD, PhD & Efstratios Vakirlis MD

  2. Department of Plastic Surgery, St.-Luc Hospital, Thessaloniki, Greece

    Alexander Dionyssopoulos MD, PhD

  3. Division of Cutaneous Pathology and Oncology, State Clinic, Hospital for Skin and Venereal Diseases, Thessaloniki, Greece

    Ioanna Mandekou-Lefaki MD, PhD

  4. Department of Urology, Interbalkan Hospital, Thessaloniki, Greece

    Ioannis Manoliadis MD, PhD

  5. Division of Plastic Surgery, Notre Dame Hospital, University of Montreal Health Center, Québec, PQ, Canada

    Andreas Nikolis MD, MSc

  6. Department of Pathology, Division of Cytology, AHEPA Hospital, Thessaloniki, Greece

    Eleni Dionyssopoulou MD

Authors
  1. Alexander Dionyssopoulos MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ioanna Mandekou-Lefaki MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Efstratios Vakirlis MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Ioannis Manoliadis MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Andreas Nikolis MD, MSc
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Eleni Dionyssopoulou MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Alexander Dionyssopoulos MD, PhD.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Dionyssopoulos, A., Mandekou-Lefaki, I., Vakirlis, E. et al. Extramammary Paget’s Disease: Isolated Localization on the Groin—Wide Local Excision With Immediate Reconstruction. Ann Surg Oncol 13, 1235–1240 (2006). https://doi.org/10.1245/s10434-006-9003-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1245/s10434-006-9003-2

Keywords

Search

Navigation