Microsoft word - fp1036.doc
FP1036 MAMMARY AND EXTRAMAMMARY PAGET’S DISEASE: STUDY OF 14
CASES AND THE THERAPEUTIC DIFFICULTIES
v. a. tanaka1, c. festa1, j. a. sanches1, l. a. r. torezan1, a. b. niwa1
1Dermatology, Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo, sao paulo, Brazil
Background: The Paget’s disease is an uncommon cutaneous neoplasm. It is classified into mammary and extramammary. Both have similar clinical and histopathological features, nevertheless they differ in sites, associated neoplasm, treatment and recurrence. Objectives: To analyze clinical evolution and interventions on patients with Paget’s disease followed in our ambulatory between January 1991 and December 2007. Methods:A retrospective review of the charts of 14 patients with Paget’s disease in 17 years follow up. The data was analyzed in relation to personal characteristics, clinical features, treatment need and disease recurrence. Results:In the 14 patients with Paget’s disease 7 had mammary Paget’s disease, 6 of them were diagnosed with associated ductal carcinoma, all of them underwent surgery and did not present recurrence during the follow up period. On the other hand, the others 7 patients with extramammary Paget’s disease underwent different kind of treatment, including: radiotherapy, CO2 laser, Imiquimod topical treatment and surgery, All of them have had recurrence of the disease. Currently 4 of those are in treatment with photodynamic therapy. Regarding the patients with mammary Paget’s disease the clinical features, evolution and treatment were similar to what has been reported in the literature. In the extramammary Paget’s disease it was observed a high recurrence rate. This is also similar to the findings in the literature. Conclusion: The treatment of the mammary Paget’s disease is well established. However in the extramammary Paget’s disease still represents a challenge because the surgery often leads to an anatomic and/or functional impairment of the affected area and the conservative treatments have a high recurrence rate.
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3-Jones RE, Austin C, Ackerman AB. Extramammary Paget’s disease. A critical
reexamination. Am J Dermatopathol 1979; 2:101–32.
4-Hendi A, Brodland DG, Zitelli JA. Extrammamary Paget’s disease: surgical
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extramammary Paget disease with topical imiquimod cream: case report and
literature review. South Med J. 2006 Apr;99(4):396-402.
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