Extramammary Paget disease of the penis as a manifestation of recurrent transitional cell carcinoma

Somers, Kathryn; Iorizzo, Luciano J.; Scott, Glynis; Mercurio, Mary Gail

doi:10.5070/d37n68m3p4

Cited by 5 publications

(2 citation statements)

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“…1,3,4 Penile EMPD of urothelial origin is extremely uncommon and we found only 18 cases published in the English literature. [5][6][7][8][9][10][11][12][13][14][15][16][17][18] We added our patient as case number 19 (Table 1). Patients' age ranged between 47 and 85 years and EMPD was diagnosed after an interval ranging between less than 1 year and up to 18 years after initial diagnosis of UC of the bladder or ureter (one patient).…”

Section: Discussionmentioning

confidence: 99%

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Penile extramammary Paget disease associated with urothelial carcinoma in situ: Case report and literature review

Tiwari

Kwast

2022

J Cutan Pathol

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Background: Extramammary Paget disease (EMPD) is an uncommon disease affecting older men and women. Clinically, it appears as a plaque lesion with an erythematous or leukoplakic background in regions with abundant apocrine glands such as female external genitalia, perineum, scrotum, and penis. Methods:We are presenting an 85-year-old patient with recurrent erythematous plaque lesions involving the penis and known to have urothelial carcinoma (UC) in situ of the bladder. A literature review of EMPD secondary to UC has been conducted through PubMed and Google Scholar search engines. Results:The histopathologic examination revealed a proliferation of Paget cells within the surface squamous epithelium. The lesional cells displayed vesicular nuclei, clear cytoplasm, and a positive staining for CK7, CK20, HER2, GATA3 as well as p40, and negative staining for SOX10, CK5/6, and CDX2. The literature review revealed 18 more cases of EMPD associated with UC, including 4 with non-invasive UC. Most of them were treated surgically, but the disease recurred in nine cases and death of disease was reported in at least four patients, all of them associated with invasive UC. Conclusion:The prognosis of penile EMPD seems to be dictated by the stage of the underlying UC.

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Section: Discussionmentioning

confidence: 99%

“…Penile EMPD of urothelial origin is extremely uncommon and we found only 18 cases published in the English literature 5‐18 . We added our patient as case number 19 (Table 1).…”

Section: Discussionmentioning

confidence: 99%

Penile extramammary Paget disease associated with urothelial carcinoma in situ: Case report and literature review

Tiwari

Kwast

2022

J Cutan Pathol

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Extramammary Paget's disease of the glans penis secondary to urethral recurrence of bladder carcinoma after radical cystectomy: A case report

et al. 2019

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Introduction Extramammary Paget's disease of the vulva secondary to urothelial carcinoma is rare. It is important to determine whether extramammary Paget's disease is primary or secondary, because the appropriate treatment strategies differ. We report a case of penile extramammary Paget's disease secondary to urothelial carcinoma recurrence. Case presentation A 75‐year‐old man who was diagnosed with bladder carcinoma and received urethra‐sparing radical cystectomy 5 years ago presented with erythema and red spots in the glans penis. Immunostaining (cytokeratin 7 and cytokeratin 20) of skin biopsy specimens suggested a secondary extramammary Paget's disease that originated from the urothelial carcinoma. Under urethroscopy, urethral recurrence was also suspected. A total penectomy was performed, and a final diagnosis of urothelial carcinoma recurrence and secondary extramammary Paget's disease of the glans penis were established. Conclusion Using immunostaining, the differential diagnosis between primary and secondary extramammary Paget's disease is more accurate. Secondary extramammary Paget's disease should be considered when a skin lesion is present on the penis of patients with urothelial carcinoma.

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Metastatic Mimics of Primary Cutaneous Lesions: Averting Diagnostic Pitfalls With Significant Repercussions

Olson¹,

LeBlanc²,

Momtahen³

et al. 2020

The American Journal of Dermatopathology

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Cutaneous metastases by solid malignancies often signify advanced disease and portend severely limited survival. Appropriate diagnosis of these lesions is particularly hampered when they closely resemble primary cutaneous tumors. In this article, we present two diagnostically challenging cases of metastatic lesions to the scalp bearing striking histologic resemblance to primary cutaneous neoplasms. One case of a metastatic urothelial carcinoma showed epidermotropism as well as histologic and immunohistochemical features virtually indistinguishable from those of a poorly differentiated squamous cell carcinoma. Next generation sequencing was performed on both the primary urothelial carcinoma and scalp malignancy revealing an identical BRAF p. S467L somatic mutation, confirming the diagnosis. Another case of metastatic renal cell carcinoma showed clinical and histomorphologic features highly reminiscent of a pyogenic granuloma. These cases demonstrate the potential of metastatic lesions to assume a myriad array of innocuous disguises and underscore the vigilance required to avoid misdiagnosis. In addition, we highlight the emerging role of molecular strategies in resolving these problematic cases.

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Extramammary Paget disease of the penis as a manifestation of recurrent transitional cell carcinoma

Cited by 5 publications

References 0 publications

Penile extramammary Paget disease associated with urothelial carcinoma in situ: Case report and literature review

Penile extramammary Paget disease associated with urothelial carcinoma in situ: Case report and literature review

Extramammary Paget's disease of the glans penis secondary to urethral recurrence of bladder carcinoma after radical cystectomy: A case report

Metastatic Mimics of Primary Cutaneous Lesions: Averting Diagnostic Pitfalls With Significant Repercussions

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