Laparoscopic extralevator abdominoperineal excision for the treatment of perianal Paget's disease

Abstract

Rational: Perianal Paget's disease (PPD) is a very rare intraepithelial adenocarcinoma. Very few cases of PPD have been reported till date, so the treatment remains controversial and more experience is needed. Patient concerns: A 73-year-old female was admitted to several hospitals with diagnosed as “perianal eczema” in perianal lesion. After a variety of treatments, the patient's condition did not improve. Diagnoses: Abdominopelvic computed tomography and rectal magnetic resonance imaging showed thickening of the soft tissue around the anus, with significant enhancement. Histologic examination revealed the state of Paget's cells. Interventions: Laparoscopic Extralevator Abdominoperineal Excision (ELAPE) surgery was performed at our department. Outcomes: The patient recovered well. After 10 months, a check-up revealed that her perianal area was disease-free. Lessons: The aim of this report was to present the characteristics of PPD in order to improve its diagnosis and treatment. Laparoscopic ELAPE is a successful therapy.