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

Abstract

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.

Pagetoid spread of urothelial carcinoma controlled without resection

“…The usefulness of CK‐7, CK‐20, and GCDFP‐15 in EMPD diagnosis has been reported. 2 , 3 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 As CK‐7 is positive in primary and secondary EMPD, it could not be conclusive. Conversely, CK‐20 and GCDFP‐15 were useful in diagnosing secondary EMPD.…”

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

“…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).…”

“…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).…”

Extramammary Paget Disease of Peristomal Skin Secondary to Bladder Urothelial Carcinoma

“…5 Other cases exist of EMPD secondary to urothelial carcinoma, although the cutaneous manifestations presented on the apocrine-rich genital skin in these cases. 6,7 Many different modalities of treatment exist for EMPD, depending on the presence or absence of metastatic disease and the surgical candidacy of the patient. In patients with primary EMPD, treatment typically consists of surgery with wide-local excision or Mohs micrographic surgery combined with adjuvant or neoadjuvant imiquimod.…”