Li Heidi Oi-Yee, Van Alicia, Lipson Jennifer
Division of Dermatology, The Ottawa Hospital, University of Ottawa, ON, Canada.
Faculty of Medicine, University of Ottawa, ON, Canada.
SAGE Open Med Case Rep. 2025 Jul 8;13:2050313X251350334. doi: 10.1177/2050313X251350334. eCollection 2025.
Extramammary Paget's disease is a rare cutaneous malignancy that typically presents as carcinoma in situ, and instances of invasive extramammary Paget's disease are exceptionally rare. Herein, we describe a rare case of invasive extramammary Paget's disease of the scrotum. A 91-year-old male presented with an over 10-year history of a granulomatous rash with serous discharge, refractory to various topical therapies and weekly wound care. Physical examination revealed a well-demarcated, erythematous, mamillated, eroded plaque with arcuate borders involving the left inguinal crease and scrotum. A punch biopsy showed intra-epidermal and invasive carcinoma with focal pagetoid spread and intracytoplasmic mucin. The favored diagnosis was primary, invasive extramammary Paget's disease. The patient underwent a wide local excision and routine imaging surveillance and remains recurrence-free at 1-year follow-up. Given that extramammary Paget's disease remains commonly misdiagnosed, leading to delays in treatment, dermatologists should be aware of this diagnosis, particularly for elderly patients presenting with non-specific genital lesions recalcitrant to routine treatment.
乳房外佩吉特病是一种罕见的皮肤恶性肿瘤，通常表现为原位癌，而侵袭性乳房外佩吉特病的病例极为罕见。在此，我们描述一例罕见的阴囊侵袭性乳房外佩吉特病病例。一名91岁男性，有超过10年的肉芽肿性皮疹伴浆液性渗出病史，对各种局部治疗和每周一次的伤口护理均无效。体格检查发现一个边界清晰、红斑状、乳头状、糜烂的斑块，边界呈弧形，累及左腹股沟皱襞和阴囊。穿刺活检显示表皮内和侵袭性癌，伴有局灶性派杰样扩散和胞质内黏液。最可能的诊断是原发性侵袭性乳房外佩吉特病。患者接受了广泛局部切除和常规影像学监测，在1年随访时无复发。鉴于乳房外佩吉特病仍常被误诊，导致治疗延误，皮肤科医生应了解这一诊断，尤其是对于出现对常规治疗无效的非特异性生殖器病变的老年患者。
