Electron microscopy in in situ and invasive vulvar Paget's disease

Paget’s disease of the breast is a rare type of cancer of the nipple–areola complex and that is often associated with an underlying in situ or invasive carcinoma. It is often misdiagnosed as eczema of breast and treatment is delayed. Here we present a case where a 30 year old female presented with itching ulceration and destruction of her left nipple. She was treated initially by local physicians by applying local ointments but as her condition did not improve she was admitted to department of surgery Shaheed Suhrawardy Medical College hospital where she was diagnosed as Paget’s disease with infiltrating ductal cell carcinoma. She underwent modified radical mastectomy with axillary clearance and referred to oncology department for further management. J Shaheed Suhrawardy Med Coll, June 2019, Vol.11(1); 81-83

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Not All Cases of Mammary Paget’s Disease are Cytokeratin-7 Positive: A Challenging Diagnosis!

International Journal of Surgical Pathology ◽

10.1177/10668969211002920 ◽

2021 ◽

pp. 106689692110029

Author(s):

Kerschen Anja ◽

Dano Hélène ◽

Van Eeckhout Pascal ◽

Marot Liliane ◽

Van Bockstal Mieke

Keyword(s):

Present Report ◽

Paget’S Disease ◽

Growth Factor Receptor ◽

Punch Biopsy ◽

Paget's Disease ◽

Cytokeratin 7 ◽

In Situ Carcinoma ◽

Epidermal Growth ◽

Mammary Paget’S Disease

Mammary Paget’s disease accounts for 1% to 3% of all breast tumors and manifests as a chronic eczematous lesion of the areolar skin. It can occur without any underlying neoplasia or can be present in association with an underlying invasive and/or in situ carcinoma of the breast. The present report describes a challenging nipple punch biopsy showing an infiltration of the lower third to two-thirds of the epidermis by large, ovoid, neoplastic cells. The morphology was consistent with mammary Paget's disease, although immunohistochemistry for cytokeratin-7 (CK7) was repeatedly negative. This resulted in an initial misdiagnosis and, subsequently, a delay in the patient's follow-up. Additional immunohistochemistry for GATA binding protein 3 (GATA3) and human epidermal growth factor receptor 2 (HER2), as well as a second opinion of a breast pathologist, resulted in the diagnosis of mammary Paget's disease. The aim of this article is to raise awareness among pathologists and prevent them from misdiagnosing CK7-negative Paget disease of the breast.

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Expression of programmed cell death ligand 1 (PD‐L1) at in situ and invasive extramammary Paget’s disease and literature review

Australasian Journal of Dermatology ◽

10.1111/ajd.13607 ◽

2021 ◽

Author(s):

Junji Kato ◽

Shintaro Sugita ◽

Kohei Horimoto ◽

Sayuri. Sato ◽

Daisuke Yoneta ◽

...

Keyword(s):

Cell Death ◽

Programmed Cell Death ◽

Literature Review ◽

Paget’S Disease ◽

Paget's Disease ◽

Extramammary Paget’S Disease ◽

Extramammary Paget's Disease

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Novel operative technique of advancement urethral meatoplasty utilizing buccal mucosa for Vulvar Paget’s disease with urethral invasion: two case reports

Journal of Medical Case Reports ◽

10.1186/s13256-021-02729-1 ◽

2021 ◽

Vol 15 (1) ◽

Author(s):

Masaki Nakamura ◽

Yuji Hakozaki ◽

Shohei Iwata ◽

Yusuke Sato ◽

Katsuhiro Makino ◽

...

Keyword(s):

Urethral Stricture ◽

Buccal Mucosa ◽

Case Reports ◽

Paget’S Disease ◽

External Genitalia ◽

Skin Grafting ◽

Standard Of Care ◽

Paget's Disease ◽

Vaginal Mucosa ◽

Vulvar Paget’S Disease

Abstract Background Vulvar Paget’s disease (VPD) is a rare malignant disorder originating in the external genitalia. It occasionally invades into urethral or vaginal mucosa of female, making surgical treatment more complicating. In case of urethral invasion of Paget’s cells, systematic mapping biopsy of urethral mucosa is the standard of care to determine the range of surgical resection. Resection of urethral mucosa and simple skin grafting often result in urethral stricture after surgery, which severely deteriorates patient’s quality of life. Case presentation We applied a new technique of advancement urethral meatoplasty using buccal mucosa, in two Japanese cases of VPD with urethral invasion. After broad resection of vulvar skin together with the urethral mucosa, buccal mucosa was implanted between advanced urethral mucosa and skin graft. In both cases, we could prevent urethral stricture one year and two years after surgery, respectively. Conclusion This technique prevented urethral stricture after surgery and could be a useful technique as part of urethroplasty for VPD.

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