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Paget's disease of the groin: report of seven cases
P Yugueros1, G L Keeney, U Bite
1Division of Plastic and Reconstructive Surgery and Pathology, Mayo Graduate School of Medicine, Rochester, Minn., USA.
Abstract:
Only 27 cases of Paget's disease of the groin have been reported to the present. Our aim was to describe the clinical behavior and treatment of this disease. A retrospective analysis of patients seen at the Mayo Clinic over a period of 25 years (January of 1970 to December of 1995) was undertaken. We included patients with lesions of the groin (isolated or associated with penile/scrotal locations) and with histologic confirmation of the diagnosis. We found seven patients, all male; three patients had isolated lesions. Their mean (SD) age was 73 (8.3) years. Special stains and immunohistochemistry confirmed the diagnosis in all patients. A wide local excision was performed in every patient. Three patients had recurrence; one of them died with multiple pulmonary metastases 4 years later. Two patients presented with history of associated malignancy (prostatic and renal cell carcinoma). Paget's disease of the groin is extremely infrequent. Its origin seems not to be a simple extension from the genital area. Most diagnoses can be made by light microscopy. Wide local excision with free margins is the treatment of choice. Local recurrence occurs in half of patients with tumor-free margins by frozen section; long-term follow-up is warranted. Distant metastases occur rarely, although they can be fatal.
Insights
Paget's disease of the groin is a rare condition. Wide local excision is the recommended treatment, but recurrence is common, necessitating long-term patient follow-up.
Area of Science:
- Oncology
- Dermatology
- Pathology
Background:
- Paget's disease of the groin is exceptionally rare, with only 27 reported cases.
- Understanding its clinical behavior and optimal treatment is crucial due to its infrequency.
Purpose of the Study:
- To describe the clinical behavior and treatment of Paget's disease of the groin.
- To analyze patient data from a 25-year period to inform clinical practice.
Main Methods:
- Retrospective analysis of seven male patients diagnosed with groin Paget's disease between 1970 and 1995.
- Histologic confirmation, including special stains and immunohistochemistry, was used for diagnosis.
- All patients underwent wide local excision as the primary treatment.
Main Results:
- The mean age of patients was 73 years; three had isolated groin lesions.
- Recurrence was observed in three patients, with one succumbing to pulmonary metastases.
- Two patients had a history of associated malignancies (prostate and renal cell carcinoma).
Conclusions:
- Paget's disease of the groin is a rare entity, potentially with an origin independent of genital area extension.
- Wide local excision with clear margins is the treatment of choice.
- High recurrence rates (50% with clear margins) underscore the need for vigilant long-term follow-up.
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