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Extramammary Paget's disease with the appearance of a nodule: a case report
Xia Wang1, Wenlin Yang, Jian Yang
1Department of Dermatology, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou 510260, P. R. China. wenliny@21cn.com
Background:
Extramammary Paget's disease (EMPD) remains a rare condition with only a limited number of cases reported in the literature. EMPD is mainly composed of intraepidermal Paget cells, and possesses variable clinical behaviors and histological appearances, leading to difficulty in the diagnosis of this disease.
Case Presentation:
We here report a case of primary EMPD with the appearance of a nodule on the background of erythema. Histological assessment showed Paget cell infiltration throughout the epidermis with dermal spread. Using immunohistochemistry, the expressions of CK7, CK19, CK20, GCDFP-15, CEA, S-100 protein and bcl-2 were examined to elucidate the cellular differentiation of the carcinoma.
Conclusion:
According to the histological assessment, this case was diagnosed as primary EMPD with carcinoma cells invading into the dermis, but without lymph node infiltration.
Insights
Extramammary Paget's disease (EMPD) is a rare intraepidermal carcinoma. This case highlights a primary EMPD presenting as a nodule, with Paget cells infiltrating the epidermis and dermis but not lymph nodes.
Area of Science:
- Oncology
- Dermatopathology
Background:
- Extramammary Paget's disease (EMPD) is a rare malignancy characterized by intraepidermal Paget cells.
- EMPD presents with diverse clinical and histological features, complicating diagnosis.
Observation:
- A case of primary EMPD is presented with a nodular appearance on an erythematous background.
- Histological examination revealed Paget cell infiltration throughout the epidermis and into the dermis.
Findings:
- Immunohistochemistry was utilized to analyze the expression of various markers including CK7, CK19, CK20, GCDFP-15, CEA, S-100 protein, and bcl-2.
- The cellular differentiation of the carcinoma was investigated through these immunohistochemical markers.
Implications:
- The case was diagnosed as primary EMPD with dermal invasion but no lymph node metastasis.
- Understanding the immunohistochemical profile aids in diagnosing and characterizing EMPD.
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