Extramammary Paget's disease of the penis and scrotum

A 64-year-old Chinese man presented to the Bellevue Hospital Center Department of Dermatology with a 2-year history of an enlarging mass in his suprapubic region, which measured 7 cm x 9 cm and involved the penis and scrotum. A biopsy specimen showed extramammary Paget's disease. Twenty years earlier, while living in China in 1983, this patient had a suprapubic skin cancer which was excised, and he received radiation to the region. Extramammary Paget's disease is a rare cutaneous adenocarcinoma of epidermal origin, which is frequently associated with adnexal carcinoma and internal malignant conditions. Clinically, extramammary Paget's disease is characterized by a red, moist, eroded plaque in the anogenital region. Extramammary Paget's disease usually behaves as a slow-growing intraepithelial adenocarcinoma; however, it may become invasive and may metastasize through dermal lymphatics. The treatment of choice is wide excision.