Spiliopoulos Dimitrios, Spiliopoulos Michail, Dandolu Vani, Mastrogiannis Dimitrios
Department of Obstetrics and Gynecology, Peterborough and Stamford Hospitals NHS Trust, Peterborough, England.
Arch Gynecol Obstet. 2009 Aug;280(2):313-5. doi: 10.1007/s00404-008-0892-0. Epub 2008 Dec 27.
We report a unique case of Paget's disease of vulva and breast. Sequentially the patient had invasive ductal carcinoma of the breast, 5 years later was diagnosed with vulvar Paget's with underlying adenocarcinoma and after another 2 years was diagnosed with Paget's disease of the breast.
A 58-year-old woman with invasive ductal cancer of the left breast was treated with lumpectomy, lymph node dissection, radiation therapy and tamoxifen. Five years later and after complaints of longstanding vulvar pruritus, the patient was diagnosed with vulvar Paget's disease and treated with simple vulvectomy, which revealed a concurrent underlying adenocarcinoma. Subsequently there was recurrence of vulvar malignancy and wide local excision was performed. Seven years after the initial diagnosis of the breast cancer, a biopsy of a left areolar red, ulcerated lesion revealed Paget's disease of the breast.
Physicians need to be cognizant of the rare occurrence of mammary and extramammary Paget's disease with underlying malignancies in both locations. A thorough physical examination including biopsy is essential for early detection and appropriate management.
我们报告一例罕见的外阴佩吉特病和乳腺佩吉特病病例。该患者先后患有乳腺浸润性导管癌,5年后被诊断为外阴佩吉特病伴潜在腺癌,又过了2年被诊断为乳腺佩吉特病。
一名58岁患有左乳腺浸润性导管癌的女性接受了肿块切除术、淋巴结清扫术、放射治疗和他莫昔芬治疗。5年后,在患者主诉长期外阴瘙痒后,被诊断为外阴佩吉特病,并接受了单纯外阴切除术,结果发现同时存在潜在腺癌。随后外阴恶性肿瘤复发,进行了广泛局部切除。在最初诊断乳腺癌7年后,对左侧乳晕处红色溃疡病变进行活检,结果显示为乳腺佩吉特病。
医生需要认识到乳腺和乳腺外佩吉特病伴两处潜在恶性肿瘤的罕见情况。包括活检在内的全面体格检查对于早期发现和适当治疗至关重要。