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Insight into the Management of Vulvar Paget’s Disease: A Recurring Menace Report of 2 Cases of Moh’s Surgery with Review of Literature

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Indian Journal of Gynecologic Oncology Aims and scope Submit manuscript

Abstract

Extramammary Paget’s disease of vulva (EMPD) is a superficial cancer that often affects only the epidermis but which has the potential to spread to a significant portion of the anogenital region's surface. When dealing with such tumors, it is important to strike a compromise between the need for cure and treatment-related morbidity. Due to the disease's rarity, there is also little and discordant clinicopathologic data available. Recurrent operations have a significant morbidity and deformity burden, and the traditional surgical treatment of EMPD is associated with a high inherent recurrence rate. In this report, we present two cases in which we did Moh’s surgery for EMPD in two separate case scenarios. For one of these cases, we also performed the Lotus flap vulvoperineal reconstruction. We bring emphasis to the fact that Moh's micrographic surgery (MMS), which has a comparatively lower recurrence rate, a higher incidence of tissue salvage, and preserves vital tissue, is a potential alternative for treating EMPD than conventional excision. MMS enables microscopic visualization of the entire margin and the excision of only the affected tissue.

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Authors and Affiliations

  1. Department of Gynaecologic Oncology, Dr B. Borooah Cancer Institute (A Grant in Aid Unit of Dept of Atomic Energy Govt. of India and Tata Memorial Hospital Mumbai), Guwahati, India

    Debabrata Barmon, Apoorva Tak & Upasana Baruah

  2. Department of Plastic and Reconstructive Surgery, Dr B. Borooah Cancer Institute (A Grant in Aid Unit of Dept of Atomic Energy Govt. of India and Tata Memorial Hospital Mumbai), Guwahati, India

    Sumanjit Boro

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  1. Debabrata Barmon
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  2. Apoorva Tak
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Correspondence to Apoorva Tak.

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Barmon, D., Tak, A., Boro, S. et al. Insight into the Management of Vulvar Paget’s Disease: A Recurring Menace Report of 2 Cases of Moh’s Surgery with Review of Literature. Indian J Gynecol Oncolog 21, 14 (2023). https://doi.org/10.1007/s40944-022-00685-2

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  • DOI: https://doi.org/10.1007/s40944-022-00685-2

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