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[外阴部乳房外佩吉特病——病例报告]

[Extramammary Paget´s disease of the vulva - a case report].

作者信息

Kolářová D, Havránková A, Líbalová P, Frühaufová S, Vernerová Z, Kučera E

出版信息

Ceska Gynekol. 2014 Nov;79(5):394-8.

Abstract

OBJECTIVE

Analysis of one case of vulvar extramammary Paget´s disease (EMPD) and associated well differentiated endometrial adenocarcinoma.Desing: A case report.

METHODS AND RESULTS

On this case report we present current theoretical knowledge about EMPD, difficulty of diagnostics, treatment and dispensarization the patients with this rare intraepithelial non-squamous neoplasia. We report a rare case of a 62 years old female patient with extramammary Paget´s disease of vulva and associated well differentiated endometrial adenocarcinoma.

CONCLUSIONS

EMPD is a rare intraephitelial non-squamous neoplasia, which represents less then 1% vulvar tumors. Predominantly it affects white women between 60 and 80 years of age. EMPD occurs in cutaneous areas bearing apocrine glands - vulva, perineum, perianal area, axilla, penis, scrotum and rarely region of tights or buttocks. It is characterized microscopically by the presence of specific tumor cells called Paget´s cells - atypical large cells with pale clear cytoplasm and large round nuclei.

KEYWORDS

extramammary Paget´s disease, EMPD, Paget´s cells, vulvectomy, imiquimod 5%, photodynamic therapy, imunotherapy, radiotherapy.

摘要

目的

分析1例外阴部乳腺外佩吉特病(EMPD)合并高分化子宫内膜腺癌的病例。设计:病例报告。

方法与结果

在本病例报告中,我们阐述了目前关于EMPD的理论知识、诊断难点、治疗方法以及对患有这种罕见上皮内非鳞状肿瘤患者的处理。我们报告了1例罕见的62岁女性患者,患有外阴部乳腺外佩吉特病并合并高分化子宫内膜腺癌。

结论

EMPD是一种罕见的上皮内非鳞状肿瘤,占外阴肿瘤的比例不到1%。主要影响60至80岁的白人女性。EMPD发生于含有顶泌汗腺的皮肤区域——外阴、会阴、肛周区域、腋窝、阴茎、阴囊,极少发生于大腿或臀部区域。其显微镜下特征为存在一种特定的肿瘤细胞,称为佩吉特细胞——具有淡而清亮细胞质和大圆形细胞核的非典型大细胞。

关键词

乳腺外佩吉特病;EMPD;佩吉特细胞;外阴切除术;5%咪喹莫特;光动力疗法;免疫疗法;放射疗法

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