膀胱尿路上皮癌复发后，围绕皮肤输尿管造口的继发性乳房外佩吉特病1例。

A Case of Secondary Extramammary Paget's Disease Surrounding a Cutaneous Ureterostoma After Recurrence of Bladder Urothelial Carcinoma.

作者信息

Mizoguchi Masahiro, Chihara Ichiro, Sano Keisuke, Kimura Tomokazu, Kandori Shuya, Negoro Hiromitsu, Mathis Bryan J, Kawai Hitomi, Matsubara Daisuke, Nishiyama Hiroyuki

机构信息

Department of Urology Institute of Medicine, University of Tsukuba Tsukuba Ibaraki Japan.

Department of Cardiovascular Surgery Institute of Medicine, University of Tsukuba Tsukuba Ibaraki Japan.

出版信息

IJU Case Rep. 2025 Mar 27;8(3):266-270. doi: 10.1002/iju5.70021. eCollection 2025 May.

DOI:10.1002/iju5.70021

PMID:40336751

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12055229/

Abstract

INTRODUCTION

Secondary extramammary Paget's disease features intraepidermal carcinoma caused by tumor invasion and migration into adjacent skin.

CASE PRESENTATION

A 68-year-old man underwent radical cystectomy and bilateral cutaneous ureterostomy for bladder cancer and right ureteral cancer. Postoperative follow-up computed tomography and urine cytology at 3 years suggested right ureteral cancer recurrence. Contemporaneous erythema and bulging of the skin around the right ureterocutaneous fistula were observed, necessitating retroperitoneoscopic nephroureterectomy and peristomal skin resection. Pathology revealed urothelial carcinoma with T2 disease at the lower ureter, plus spreading cytokeratin 7+ and cytokeratin 20+ pagetoid cells clustered within the epidermis indicative of secondary Paget's disease.

CONCLUSION

In cases of recurrent upper urothelial carcinoma after urinary diversion, patients may develop secondary extramammary Paget's disease of the skin.

摘要

引言

继发性乳腺外佩吉特病的特征是肿瘤侵袭并迁移至邻近皮肤导致的表皮内癌。

病例介绍

一名68岁男性因膀胱癌和右侧输尿管癌接受了根治性膀胱切除术和双侧皮肤输尿管造口术。术后3年的随访计算机断层扫描和尿液细胞学检查提示右侧输尿管癌复发。同时观察到右侧输尿管皮肤造瘘口周围皮肤出现红斑和隆起，需要进行后腹腔镜肾输尿管切除术和造口周围皮肤切除术。病理显示输尿管下段为T2期尿路上皮癌，此外，表皮内有散在的细胞角蛋白7阳性和细胞角蛋白20阳性的佩吉特样细胞，提示继发性佩吉特病。