CPC Case of the Month

EXTRMAMMARY PAGET'S DISEASE OF THE SCROTUM WITH UNDERLYING INVASIVE CARCINOMA

Submitted by: David Peng, MD and Terrance O'Grady, MD, University of California - San Diego

CLINICAL

A 79-year-old male with a 24 month history of an enlarging lichenified plaque of the scrotum. Past history includes Paget’s disease of the bone in 1996 and prostate cancer in 1997. The lesion began as a collection of smaller red papules which appeared soon after radical prostatectomy in 1997. In 2003 the plaque involved the majority of the scrotum, characterized by general lichenification interspersed with small, focal areas of maceration and erosion. The plaque is studded with 1-2 mm vascular papules. A 4 mm biopsy was taken from the right scrotal region in April 2003 after multiple topical regimens failed to produce any improvement.

IMPORTANT FEATURE:
REASON FOR PRESENTATION

Instructive case.

REFERENCES

1. Pierie JP, Choudry U, Muzikansky A, et al. Prognosis and management of extramammary Paget’s disease and the association with secondary malignancies; J Am Coll Surg 2003;196:45-50.

2. Ng, LG, Yip S K, Tan PH. Extramammary Paget’s Disease of Scrotum. Urology 2001;58:105.

3. Van Randenborgh H, Paul R, Nahrig J, et al, Extramammary Paget’s Disease of the Penis and Scrotum; J Urol 2002;168:2540-2541.

4. Arango O,Bielsa O, Lorente JA, et al, Hemiscrotectomy with contralateral testicular transposition for scrotal cancer; J Urol 2002;168:1406-1407.