Biopsies

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Sentinel Lymph Node Biopsy May Predict Prognosis in Extramammary Paget Disease

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Sentinel Lymph Node Biopsy May Predict Prognosis in Extramammary Paget Disease

Routine sentinel lymph node biopsy (SLNB) may help predict prognosis in patients with extramammary Paget disease (EMPD) of the genital area without clinical lymph node enlargement, according to study results published in the Journal of Dermatology.

Researchers sought to determine whether clinical characteristics and biomarkers before primary tumor resection could predict the invasion level of primary tumors and sentinel lymph node (SLN) metastasis in patients with EMPD. They retrospectively reviewed the data of patients who had primary tumor resection and SLNB for EMPD in the genital region from August 2002 to December 2024 at a single center.

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Preoperative mapping biopsies with local excision in the treatment of Extramammary Paget Disease

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Preoperative mapping biopsies with local excision in the treatment of Extramammary Paget Disease

Surgical excision of extramammary Paget disease (EMPD) is associated with a high local recurrence rate. This study found that PMB before local excision significantly reduced the risk of recurrence when treating EMPD. Further studies are necessary to compare the recurrence rates of PMB, Mohs micrographic surgery and WLE for EMPD.

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Incidental finding of extramammary Paget's disease during active surveillance for early-stage prostate cancer in a prostate biopsy

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Incidental finding of extramammary Paget's disease during active surveillance for early-stage prostate cancer in a prostate biopsy

Skin tissue contamination within transcutaneous visceral organ biopsies is seldom found. We encountered a rare case of extramammary Paget's disease incidentally diagnosed by prostate biopsy during active surveillance for prostate cancer. Although the perianal region is a common site of extramammary Paget's disease, early-stage extramammary Paget's disease is often asymptomatic. Thus, during a transcutaneous biopsy, it is important to consider the appearance of the skin and the pathological features of migrating skin tissue.

The role of sentinel lymph node biopsy in extramammary paget disease

The role of sentinel lymph node biopsy in extramammary paget disease

Sentinel lymph node biopsy is increasingly used to detect subclinical nodal metastases in extramammary Paget disease. We performed a comprehensive systematic review of the literature to further explore the role of sentinel lymph node biopsy in extramammary Paget disease. Sentinel lymph node biopsy is a useful tool to screen for subclinical nodal metastases in invasive disease, and can be used to help guide clinical management.

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Extramammary Paget Disease

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Extramammary Paget Disease

Extramammary Paget disease (EMPD) is a rare dermatologic condition that frequently presents in areas where apocrine sweat glands are abundant, most commonly the vulva, although perineal, scrotal, perianal, and penile skin may also be affected. Lesions clinically present as erythematous, well-demarcated plaques that may become erosive, ulcerated, scaly, or eczematous. Extramammary Paget disease has a female predominance and usually occurs in the sixth to eighth decades of life. Professionals disagree about many aspects of EMPD, for example, the prevalence of concurrent vulvar adenocarcinoma or invasive EMPD, association with regional and distant cancers, and recurrence rates following surgical excision. Early recognition is imperative because the diagnosis is frequently delayed and there is a high incidence of associated invasive disease.

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Usefulness of Mapping Biopsy in the Treatment of Penoscrotal Extramammary Paget’s Disease

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Usefulness of Mapping Biopsy in the Treatment of Penoscrotal Extramammary Paget’s Disease

Park et al. report their experience in the management of extramammary Paget’s Disease (EMPD) of the penoscrotal region and specifically compare outcomes among cohorts of men with the disease who either did or did not undergo mapping biopsies prior to their definitive surgical procedure. The rationale for the study and this comparison is that Paget’s disease initially spreads insidiously through the epidermis, sometimes in a single-cell fashion, and establishing the diagnosis can be very difficult subsequent to intraoperative frozen sections. Thus, several studies have described the use of outpatient mapping biopsies under more permanent section pathology techniques to facilitate the diagnosis and to ‘clear’ the surgical margins (references 19–21 in the article). This should theoretically lead to a lower incidence of positive frozen section margins intraoperatively, a lower incidence of positive permanent section margins, and lower recurrence rates for patients.

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Mohs with CK-7 staining: 98% 5-year cure rate for extramammary Paget disease

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Mohs with CK-7 staining: 98% 5-year cure rate for extramammary Paget disease

Mohs surgery with cytokeratin-7 immunohistochemistry staining effected complete removal of extramammary Paget disease and resulted in a 5-year, 95% recurrence-free cure rate. The results are significantly better than the often-cited 77% cure rate seen with Mohs surgery alone, Dr. Ali Alexander Damavandy said at the annual meeting of the American College of Mohs Surgery.

“These are statistically significant and clinically substantial results,” said Dr. Damavandy, a procedural dermatology fellow at the University of Pennsylvania, Philadelphia. “With this method you can tell a patient that in 5 years, he has a 95% chance of still not having the tumor. The high recurrence-free rate we have seen supports the view that Mohs surgery with cytokeratin-7 [CK-7] immunohistochemistry should be considered the curative treatment of choice for both primary and recurrent extramammary Paget disease of the skin.”

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