1、1674 West China Medical Journal Vol.29 No.9 Sep. 2014 D 201429 | 5Pageths1 p2 301K1 “ )| 5 Paget h “5+#ZEb ZE , 2008 M 2013 M Wh L18 | 5 Pageth M - 55j81 ( 69 bh 9j 18 M ( 6 M 3bK1 “5VC 94.4% 8 1A66.7%a.e11.1%a5.6%b (h1 v M“ bT HW 8j52 ( 34b h _4 U 4 | Mh1 # 1 C? 14 M“ ( h1?b 1 h _4 Ui F Sr /F 20C“
2、%M 1 h _4 UsFV hi S# 18kMb | 5 Pagethn M bC#*h _ b m , hMaiF b1oM| 5 Pageth DS ADOI:10.7507/1002-0179.20140511 Diagnosis and Therapeutic Methods of Paget s Disease XU Yang1, CHEN Li-bo2, LIN Ying-ying3, CEN Ying1. 1. Department of Burn and Plastic; 2. Department of Urology Surgery; 3. Deaprtment of
3、Pathology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. ChinaCorresponding author: CEN Ying, E-mail: Abstract Objective To investigate the clinical features, diagnosis, therapeutic methods of Pagets disease involving the scrotum. MethodsThe clinical data of 18 patients wit
4、h Pagets disease treated in our hospital between 2008 and 2013 involving the scrotum were analyzed retrospectively. The patients age ranged from 55 to 81 years old with an average of 69. The disease course ranged from 9 months to 18 years, averaging 6 years and 3 months. The main clinical pr was itc
5、hing (94.4%), followed by exudation (66.7%), pain (11.1%), and desquamation (5.6%). All patients underwent extended resection. Results The patients were followed up for 8 to 52 months averaging 34 months. Four patients postoperative pathological report found focus on the excision margin, and one of
6、them had local recurrence after 14 months. The remaining 14 cases had no local recurrence. One patients pathological fi ndings reported Pagets disease combined with invasive adenocarcinoma which invaded subcutaneous fat tissue layer, and this patient developed inguinal lymph node metastasis 20 month
7、s after operation. Another patient combined with adenocarcinoma which invaded deep dermis layer developed liver and lung metastasis 18 months after operation. Conclusions Pagets disease involving the scrotum is more commonly seen in older patients, and its main clinical presentation is itching. Page
8、ts disease is usually misdiagnosed, so patients should undergo pathological examination early to clear diagnosis. Surgery is the main treatment. Pagets disease combined with invasive adenocarcinoma has poor prognosis.Key wordsPagets disease of scrotum; Diagnosis; Therapy; PrognosisT +vD 610041 1 S 2
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14、 u aiD 17 0 z 7 ib i? % p/ a b3.4| 5 Pageth ? SU V A1“v | %hM %M# # =# 20 ?11bF 1 #|a“avy 20 cm6 1 #|a“ 15 cmv M“ z (?C?bF2 S# 8a10 1 4 S# /F 4 20 C“ %M 10 18CkMb Vn ?KV #q m 5 zhM # a / .X SU u %5 12bh s 9 1y b = Pageth z 9? Q m V1314bPagethF15F3 F 2 C %)Mb8 | 5 Paget hYZ #*h _ b m M“ “ -B Mr m ? 0
15、 s m ?E M“ V I nb b1yh1v7b m ? S# g)M* v M“ M zb4 ID 1 B Ray B, Whitmore WF Jr. Experience with carcinoma of the V1 “5 a m Z T# TI| h1Savl hM M m HW 1 #| 6cm4cm 1 u h1 v M“ + 35 ?2 #| 4 cm 1 u # q h1 v M“ + 38 ?3 K| 5 3cm2 cm =# /F(nF #+ h1 v M“ + 37 ?4 K| 5 3cm3 cm i Fr /F h1 v M“ + M 36 20“%M5 #|
16、7 cm h1 v M“ + 49 ?6 K| 5 7 cm h1 v M“ + 52 ?7 K| 5 7cm8 cm + h1 v M“ + 31 1 M ? V ?v8 #| 6cm4 cm # h1 v M“ + 31 ?9 #| 10cm6 cm h1 v M“ + 30 ?10 K| 5 4cm4 cm sFV h i S# h1 v M“ + 28 18kM11 #| 7cm8 cm + h1 v M“ + 25 ?12 K| 5 3cm5 cm h1 v M“ + 34 ?13 #|a “8cm6 cm h1 v M“ + 33 ?14 #|a“avy 20 cm / +| ?
17、M“ + U gy + 35 ?15 #|a“ 4cm4 cm + h1 v M“ + 43 ?16 #|a“ 8cm5 cm h1 v M“ + 42 ?17 K| 5 3cm3 cm h1 v M“ + 30 ?18 #|a “ 15 cm h1 v M“ + 8 ?1677D 201429 West China Medical Journal Vol.29 No.9 Sep. 2014of scrotum: report of 25 cases and literature reviewJ. Urol Oncol, 2008, 28(1): 28-33. 10B Yang WJ, Kim
18、 DS, Im YJ, et al. Extramammary Pagets disease of penis and scrotumJ. Urology, 2005, 65(5): 972-975. 11B Ng LG, Yip SK, Tan PH. Extramammary Pagets disease of scrotumJ. Urology, 2001, 58(1): 105-106. 12B Tsut sumida A, Yamamoto Y, Minakawa H, et al. Indications for lymphnode dissection in the treatm
19、ent of extrmammary Pagets diseaseJ. Dermatol Surg, 2003, 29(1): 212-224. 13B Parker LP, Parker JR, Bodurka-Bevers D, et al. Pagets disease of pathology pattern of involvement and prognosisJ. Gynecol Oncol, 2000, 77(1): 183-189. 14B Fanning J, Lambert HC, Hale TM, et al. Pagets disease of the vulva:
20、prevalence of associated vulvar adenocarcinoma, invasive Pagets disease, and recurrence after surgical excisionJ. Am J Obstet Gynecol, 1999, 180(1): 24-27. 15B Parker LP, Parker JR, Bodurka-Bevers D, et al. Pagets disease of the vulva: pathology, pattern of involvement, and prognosisJ. Gynecol Oncol
21、, 2000, 77(1): 183-189.l 2013-11-28 2014-07-09 I Sa / scrotumJ. J Urol, 1977, 117(6): 741-745. 2 B Lai YL, Yang WG, Tsay PK, et al . Penoscrotal extramammary Pagets disease: a review of 33 cases in a 20-year experienceJ. Plast Reconstr Surg, 2003, 112(4): 1017-1023. 3 B = M , uf . | 5a| Pageth “5h s
22、 J. 3S , 2008, 14(9): 810-814. 4 B Brown RS, Lankester KJ, McCormack M, et al. Radiotherapy for perianal Pagets diseaseJ. Clin Oncol (R Coll Radio), 2002, 14(4): 272-284. 5 B Luk NM, Yu KH, Yeung WK, et al. Extramammary Pagets disease: outcome of radiotherapy with curative intentJ. Clin Exp Dermatol
23、, 2003, 28(4): 360-363. 6 B Berman B, Spencer J, Villa A, et al. Successful treatment of extramammary Pagets disease of the scrotum with imiquimod 5% creamJ. Clin Exp Dermatol 2003, 28(Suppl 1): 36-38. 7 B Shieh S, Dee AS, Cheney RT, et al . Photodynamic therapy for the treatment of extramammary Pag
24、ets diseaseJ. Br J Dermatol, 2002, 146(6): 1000-1005. 8 B Park S, Grossfeld GD, Mcaninch JW, et al. Extramammary Pagets disease of the penis and scrotum: excision, reconstruction, and evaluation of occult malignancyJ. J Urol, 2001, 166(6): 2112-2117. 9 B Zhang N, Gong K, Zhang X, et al . Extramammar
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