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Perianal Paget's Disease.

Kim CW, Kim YH, Cho MS, Min BS, Baik SH, Kim NK - Ann Coloproctol (2014)

Bottom Line: An 84-year-old Korean man was treated with topical and oral medications at a local dermatologic clinic for a year, but the symptoms did not improve.For the skin and the soft tissue defects, bilateral inferior gluteal artery perforator flap transpositions were performed.The size of the lesion was 14 cm(2) × 9 cm(2), and the lateral and the basal margins were all disease free.

View Article: PubMed Central - PubMed

Affiliation: Division of Colon and Rectal Surgery, Department of Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.

ABSTRACT
The incidence of extramammary Paget's disease (EMPD) is very low. An 84-year-old Korean man was treated with topical and oral medications at a local dermatologic clinic for a year, but the symptoms did not improve. He visited Severance Hospital and underwent a perianal skin biopsy and was finally diagnosed with EMPD. The authors performed a wide local excision according to a 1-cm margin around the lesion. For the skin and the soft tissue defects, bilateral inferior gluteal artery perforator flap transpositions were performed. The size of the lesion was 14 cm(2) × 9 cm(2), and the lateral and the basal margins were all disease free.

No MeSH data available.


Related in: MedlinePlus

Immunohistochemistry examinations: (A) H&E (×100), (B) cytokeratin 7 (×100), (C) carcinoembryonic antigen (×100), (D) C-erb B2 (×100), (E) HMB-45 (×100), and (F) mucicarmine (×100).
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Figure 2: Immunohistochemistry examinations: (A) H&E (×100), (B) cytokeratin 7 (×100), (C) carcinoembryonic antigen (×100), (D) C-erb B2 (×100), (E) HMB-45 (×100), and (F) mucicarmine (×100).

Mentions: The patient recovered without any complications. He sustained the prone position for the integrity of flaps and was kept on nil per os (nothing by mouth) with intravenous nutritional support alone for 12 days after surgery to prevent wound infection from the stool. The right drain was removed at postoperative day (POD) #6 whereas the left drain was removed at POD #12. The rectal tube was removed at POD #7. The patient started his diet at POD #13 without any problems. The pathology was proven as EMPD. The immunohistochemistry was positive for cytokeratin 7 (CK7), carcinoembryonic antigen, and C-erb B2 while it was negative for HMB-45 (Fig. 2). The lateral and the basal margins were all disease free (0.7 cm and 0.1 cm, respectively). The patient was discharged at POD #20.


Perianal Paget's Disease.

Kim CW, Kim YH, Cho MS, Min BS, Baik SH, Kim NK - Ann Coloproctol (2014)

Immunohistochemistry examinations: (A) H&E (×100), (B) cytokeratin 7 (×100), (C) carcinoembryonic antigen (×100), (D) C-erb B2 (×100), (E) HMB-45 (×100), and (F) mucicarmine (×100).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4213942&req=5

Figure 2: Immunohistochemistry examinations: (A) H&E (×100), (B) cytokeratin 7 (×100), (C) carcinoembryonic antigen (×100), (D) C-erb B2 (×100), (E) HMB-45 (×100), and (F) mucicarmine (×100).
Mentions: The patient recovered without any complications. He sustained the prone position for the integrity of flaps and was kept on nil per os (nothing by mouth) with intravenous nutritional support alone for 12 days after surgery to prevent wound infection from the stool. The right drain was removed at postoperative day (POD) #6 whereas the left drain was removed at POD #12. The rectal tube was removed at POD #7. The patient started his diet at POD #13 without any problems. The pathology was proven as EMPD. The immunohistochemistry was positive for cytokeratin 7 (CK7), carcinoembryonic antigen, and C-erb B2 while it was negative for HMB-45 (Fig. 2). The lateral and the basal margins were all disease free (0.7 cm and 0.1 cm, respectively). The patient was discharged at POD #20.

Bottom Line: An 84-year-old Korean man was treated with topical and oral medications at a local dermatologic clinic for a year, but the symptoms did not improve.For the skin and the soft tissue defects, bilateral inferior gluteal artery perforator flap transpositions were performed.The size of the lesion was 14 cm(2) × 9 cm(2), and the lateral and the basal margins were all disease free.

View Article: PubMed Central - PubMed

Affiliation: Division of Colon and Rectal Surgery, Department of Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.

ABSTRACT
The incidence of extramammary Paget's disease (EMPD) is very low. An 84-year-old Korean man was treated with topical and oral medications at a local dermatologic clinic for a year, but the symptoms did not improve. He visited Severance Hospital and underwent a perianal skin biopsy and was finally diagnosed with EMPD. The authors performed a wide local excision according to a 1-cm margin around the lesion. For the skin and the soft tissue defects, bilateral inferior gluteal artery perforator flap transpositions were performed. The size of the lesion was 14 cm(2) × 9 cm(2), and the lateral and the basal margins were all disease free.

No MeSH data available.


Related in: MedlinePlus