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Photodynamic technology for delineating surgical margins in recurrent extramammary Paget's disease: a case report
Xuan Guo1,2, Haixia Wang1,2, Xueqing Wang1,2
1Dermatology Hospital of Shandong First Medical University, Jinan, Shandong, China.
Background:
Extramammary Paget's disease (EMPD) is a rare cutaneous malignancy characterized by a high propensity for recurrence and metastasis. EMPD typically presents as slowly progressive, ill-defined erythematous plaques, which are often misdiagnosed as inflammatory dermatoses, leading to delayed diagnosis. Surgical excision remains the standard treatment for EMPD; however, due to ambiguous lesion borders, positive surgical margins frequently occur, resulting in a high local recurrence rate. In this study, we aimed to evaluate the clinical efficacy and safety of photodynamic diagnosis (PDD) in assisting surgical margin delineation for cutaneous tumors.
Methods:
A retrospective analysis was conducted on a patient with histologically confirmed scrotal EMPD. Despite multiple prior Mohs procedures and wide excisions, the disease relapsed. Ultimately, fluorescence-guided photodynamic technology was adopted to precisely demarcate tumor boundaries, followed by surgical excision according to the delineated margins.
Results:
Postoperative histopathological examination confirmed clear surgical margins and complete tumor resection. The patient is under continuous follow-up.
Conclusion:
Photodynamic technology facilitates accurate tumor margin delineation, guidessurgical resection extent, reduces recurrence risk, and improves patient comfort.
