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Extramammary Paget's disease of the perianal region

H Tulchinsky1, O Zmora, E Brazowski

  • 1Department of Surgery B, Tel-Aviv Sourasky Medical Centre, Tel-Aviv University, Tel Aviv, Israel. hamtul@hotmail.com

Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland
|April 28, 2004
PubMed
Abstract

Insights

Perianal Paget's disease (PPD) treatment outcomes show significant recurrence rates after surgery. Non-surgical options may be considered for non-invasive PPD, reserving radical surgery for invasive disease or treatment failures.

Area of Science:

  • Dermatology
  • Surgical Oncology
  • Oncology

Background:

  • Perianal Paget's disease (PPD) is a rare condition.
  • Surgical excision is the standard treatment for PPD.
  • High recurrence rates and morbidity, especially in elderly patients, pose challenges.

Purpose of the Study:

  • To review institutional experience with PPD.
  • To evaluate treatment outcomes for PPD.
  • To question current surgical treatment paradigms for PPD based on histopathology and outcomes.

Main Methods:

  • Retrospective chart review of PPD patients (1996-2002).
  • Analysis of treatment outcomes.
  • Literature review for comparative data.

Main Results:

  • Five patients with in situ PPD (median age 68) were analyzed.
  • Four patients underwent surgical excision; one received photodynamic therapy.
  • Outcomes included two disease-free, one persistent disease, and two local recurrences.

Conclusions:

  • Significant recurrence rates observed even after wide local excision.
  • Non-surgical modalities warrant consideration as primary treatment for non-invasive PPD.
  • Radical surgery should be reserved for treatment failures or invasive disease.

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