Sisodia Suanga, Boushey Robin, Lee Goo, Marginean Celia, Gomes Marcio M, Bhattacharya Gaurav, Dennis Kristopher
aDivision of Radiation Oncology, The Ottawa Hospital and the University of Ottawa, Ottawa, Ontario, Canada.
bDivision of General Surgery, The Ottawa Hospital and the University of Ottawa, Ottawa, Ontario, Canada.
Case Rep Gastroenterol. 2017 Mar 3;11(1):109-113. doi: 10.1159/000457789. eCollection 2017 Jan-Apr.
Extramammary Paget disease (EMPD) involving the perianal region is rare and challenging to manage. Primary EMPD involves stand-alone noninvasive lesions within the epidermis, while secondary EMPD involves phenotypically similar lesions derived from separate underlying malignancies. Differentiating between primary and secondary EMPD is challenging when no underlying malignancies are detected during workup. Continued reporting of perianal EMPD cases is encouraged so that risk stratification can be improved and patients can be managed with an appropriate level of aggressiveness. Herein, we report the case of a 74-year-old woman who chose aggressive surgical management after being diagnosed with perianal pagetoid intraepithelial carcinoma from a suspected occult underlying primary colorectal tumor.
累及肛周区域的乳腺外佩吉特病（EMPD）较为罕见，治疗颇具挑战性。原发性EMPD累及表皮内独立的非侵袭性病变，而继发性EMPD则累及源自不同潜在恶性肿瘤的表型相似的病变。当在检查过程中未检测到潜在恶性肿瘤时，区分原发性和继发性EMPD具有挑战性。鼓励持续报告肛周EMPD病例，以便改善风险分层，并能以适当的积极程度对患者进行管理。在此，我们报告一例74岁女性的病例，该患者在被诊断为疑似隐匿性潜在原发性结直肠肿瘤导致的肛周派杰样上皮内癌后，选择了积极的手术治疗。
