Invasive Paget's disease of the vulva treated with a combination of surgery and concurrent chemoradiotherapy: A case report

Inayama,Yoshihide; Abiko,Kaoru; Miyamoto,Taito; Horie,Akihito; Yamaguchi,Ken; Baba,Tsukasa; Matsumura,Noriomi; Minamiguchi,Sachiko; Mandai,Masaki

doi:10.3892/mco.2018.1719

November-2018 Volume 9 Issue 5

Full Size Image

Journals

International Journal of Molecular Medicine

International Journal of Molecular Medicine is an international journal devoted to molecular mechanisms of human disease.

International Journal of Oncology

International Journal of Oncology is an international journal devoted to oncology research and cancer treatment.

Molecular Medicine Reports

Covers molecular medicine topics such as pharmacology, pathology, genetics, neuroscience, infectious diseases, molecular cardiology, and molecular surgery.

Oncology Reports

Oncology Reports is an international journal devoted to fundamental and applied research in Oncology.

Experimental and Therapeutic Medicine

Experimental and Therapeutic Medicine is an international journal devoted to laboratory and clinical medicine.

Oncology Letters

Oncology Letters is an international journal devoted to Experimental and Clinical Oncology.

Biomedical Reports

Explores a wide range of biological and medical fields, including pharmacology, genetics, microbiology, neuroscience, and molecular cardiology.

Molecular and Clinical Oncology

International journal addressing all aspects of oncology research, from tumorigenesis and oncogenes to chemotherapy and metastasis.

World Academy of Sciences Journal

Multidisciplinary open-access journal spanning biochemistry, genetics, neuroscience, environmental health, and synthetic biology.

International Journal of Functional Nutrition

Open-access journal combining biochemistry, pharmacology, immunology, and genetics to advance health through functional nutrition.

International Journal of Epigenetics

Publishes open-access research on using epigenetics to advance understanding and treatment of human disease.

Medicine International

An International Open Access Journal Devoted to General Medicine.

November-2018 Volume 9 Issue 5

Full Size Image

Case Report Open Access

Invasive Paget's disease of the vulva treated with a combination of surgery and concurrent chemoradiotherapy: A case report

Authors:
- Yoshihide Inayama
- Kaoru Abiko
- Taito Miyamoto
- Akihito Horie
- Ken Yamaguchi
- Tsukasa Baba
- Noriomi Matsumura
- Sachiko Minamiguchi
- Masaki Mandai
View Affiliations / Copyright

Affiliations: Department of Gynecology and Obstetrics, Kyoto University Graduate School of Medicine, Kyoto, Kyoto 606‑8507, Japan, Department of Obstetrics and Gynecology, National Hospital Organization Kyoto Medical Center, Kyoto, Kyoto 612‑8555, Japan, Department of Obstetrics and Gynecology, Kinki University Faculty of Medicine, Osaka‑Sayama, Osaka 589‑8511, Japan, Department of Diagnostic Pathology, Kyoto University Graduate School of Medicine, Kyoto, Kyoto 606‑8507, Japan
Pages: 489-489
|
Published online on: September 17, 2018

https://doi.org/10.3892/mco.2018.1719
Expand metrics +

Abstract

Invasive Paget's disease of the vulva (IP) is rare among patients with vulvar cancer. Radiation therapy and chemotherapy are not considered as radical, whereas surgical resection of the tumor with abdominal lymphadenectomy is highly invasive. Thus, more effective and less invasive treatments for IP are required. The present study reports a case of a 64‑year‑old woman with IP, who was treated with a combination of surgery and concurrent chemoradiotherapy (CCRT). The patient was diagnosed with IP with suspected lymph node metastases to the inguinal and pelvic lymph nodes, after having suffered from pruritus vulvae for 7 years. Following mapping biopsy, wide local excision, bilateral inguinal lymph node resection and laparoscopic pelvic lymphadenectomy were successfully performed. The vulva was reconstructed with a local fat flap. Postoperative pathological examination revealed metastases to the bilateral superficial inguinal and the left obturator and lateral suprainguinal lymph nodes. Adjuvant CCRT (whole pelvic irradiation, 50.4 Gy with weekly cisplatin, 40 mg/m2) was completed without notable complications. Therefore, laparoscopic pelvic lymphadenectomy may be useful in determining the irradiation field for adjuvant CCRT in patients with advanced IP.

View Figures

View References

1	Parker LP, Parker JR, Bodurka-Bevers D, Deavers M, Bevers MW, Shen-Gunther J and Gershenson DM: Paget's disease of the vulva: Pathology, pattern of involvement, and prognosis. Gynecol Oncol. 77:183–189. 2000. View Article : Google Scholar : PubMed/NCBI
2	Yamamoto R, Sakuragi N, Shirato H, Shimizu M and Fujimoto S: Radiotherapy with concurrent chemotherapy for vulvar adenocarcinoma associated with extramammary Paget's disease. Gynecol Oncol. 80:267–271. 2001. View Article : Google Scholar : PubMed/NCBI
3	van der Linden M, Meeuwis KA, Bulten J, Bosse T, van Poelgeest MI and de Hullu JA: Paget disease of the vulva. Crit Rev Oncol Hematol. 101:60–74. 2016. View Article : Google Scholar : PubMed/NCBI
4	Wilkinson EJ and Brown HM: Vulvar Paget disease of urothelial origin: A report of three cases and a proposed classification of vulvar Paget disease. Hum Pathol. 33:549–554. 2002. View Article : Google Scholar : PubMed/NCBI
5	Kurman RJ, Ellenson LH and Ronnett BM: Blaustein's Pathology of the Female Genital Tract. 6th. Springer+Business Media; New York: pp. 81–86. 2011
6	Delport ES: Extramammary Paget's disease of the vulva: An annotated review of the current literature. Australas J Dermatol. 54:9–21. 2013. View Article : Google Scholar : PubMed/NCBI
7	Kurman RJ, Carcangiu ML, Herrington CS and Young RH: World Health Organization Classification of Tumours. Int Agency Res Cancer; Lyon Cedex 08: pp. 236–237. 2014
8	Deppe G, Mert I and Winer IS: Management of squamous cell vulvar cancer: A review. J Obstet Gynaecol Res. 40:1217–1225. 2014. View Article : Google Scholar : PubMed/NCBI
9	Mak RH, Halasz LM, Tanaka CK, Ancukiewicz M, Schultz DJ, Russell AH and Viswanathan AN: Outcomes after radiation therapy with concurrent weekly platinum-based chemotherapy or every-3-4-week 5-fluorouracil-containing regimens for squamous cell carcinoma of the vulva. Gynecol Oncol. 120:101–107. 2011. View Article : Google Scholar : PubMed/NCBI
10	Moore DH, Ali S, Koh WJ, Michael H, Barnes MN, McCourt CK, Homesley HD and Walker JL: A phase II trial of radiation therapy and weekly cisplatin chemotherapy for the treatment of locally-advanced squamous cell carcinoma of the vulva: A gynecologic oncology group study. Gynecol Oncol. 124:529–533. 2012. View Article : Google Scholar : PubMed/NCBI
11	Besa P, Rich TA, Delclos L, Edwards CL, Ota DM and Wharton JT: Extramammary Paget's disease of the perineal skin: Role of radiotherapy. Int J Radiat Oncol Biol Phys. 24:73–78. 1992. View Article : Google Scholar : PubMed/NCBI
12	Hata M, Omura M, Koike I, Wada H, Miyagi E, Tayama Y, Odagiri K, Minagawa Y, Ogino I and Inoue T: Role of radiotherapy as curative treatment of extramammary Paget's disease. Int J Radiat Oncol Biol Phys. 80:47–54. 2011. View Article : Google Scholar : PubMed/NCBI
13	De Hullu JA, Hollema H, Lolkema S, Boezen M, Boonstra H, Burger MP, Aalders JG, Mourits MJ and Van Der Zee AG: Vulvar carcinoma. The price of less radical surgery. Cancer. 95:2331–2338. 2002. View Article : Google Scholar : PubMed/NCBI
14	Hacker NF, Eifel PJ and van der Velden J: Cancer of the vulva. Int J Gynecol Obstet. 119 Suppl 2:S90–S96. 2012. View Article : Google Scholar
15	Kodama S, Kaneko T, Saito M, Yoshiya N, Honma S and Tanaka K: A clinicopathologic study of 30 patients with Paget's disease of the vulva. Gynecol Oncol. 56:63–70. 1995. View Article : Google Scholar : PubMed/NCBI
16	Kato T, Fujimoto N, Fujii N and Tanaka T: Mapping biopsy with punch biopsies to determine surgical margin in extramammary Paget's disease. J Dermatol. 40:968–972. 2013. View Article : Google Scholar : PubMed/NCBI
17	Zhu Y, Ye DW, Chen ZW, Zhang SL and Qin XJ: Frozen section-guided wide local excision in the treatment of penoscrotal extramammary Paget's disease. BJU Int. 100:1282–1287. 2007. View Article : Google Scholar : PubMed/NCBI
18	Walker JL, Piedmonte MR, Spirtos NM, Eisenkop SM, Schlaerth JB, Mannel RS, Spiegel G, Barakat R, Pearl ML and Sharma SK: Laparoscopy compared with laparotomy for comprehensive surgical staging of uterine cancer: Gynecologic Oncology Group Study LAP2. J Clin Oncol. 27:5331–5336. 2009. View Article : Google Scholar : PubMed/NCBI
19	Klemm P, Marnitz S, Köhler C, Braig U and Schneider A: Clinical implication of laparoscopic pelvic lymphadenectomy in patients with vulvar cancer and positive groin nodes. Gynecol Oncol. 99:101–105. 2005. View Article : Google Scholar : PubMed/NCBI

Journals

International Journal of Molecular Medicine

International Journal of Oncology

Molecular Medicine Reports

Oncology Reports

Experimental and Therapeutic Medicine

Oncology Letters

Biomedical Reports

Molecular and Clinical Oncology

World Academy of Sciences Journal

International Journal of Functional Nutrition

International Journal of Epigenetics

Medicine International

Invasive Paget's disease of the vulva treated with a combination of surgery and concurrent chemoradiotherapy: A case report

This article is mentioned in:

Abstract

Figure 1

Figure 2

Figure 3

Related Articles