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Indian J Dermatol Venereol Leprol. 2019 Oct 18. doi: 10.4103/ijdvl.IJDVL_382_18. [Epub ahead of print]

First-time versus recurrent penoscrotal extramammary Paget's disease: Clinicopathological characteristics and risk factors in 164 Chinese male patients.

Author information

1
Department of Urology, Huashan Hospital, Fudan University, Shanghai, China.
2
Department of Nursing, Huashan Hospital, Fudan University, Shanghai, China.

Abstract

Background:

Penoscrotal extramammary Paget's disease is a rare, slow-growing neoplasm with high frequency of local recurrence.

Aims:

The aim of this study was to investigate the difference in clinicopathological characteristics between first-time and recurrent penoscrotal Paget's disease, and to discover the potential risk factors of recurrence.

Methods:

Between January 2007 and February 2014, a total of 164 Chinese patients with biopsy-proven tramammary Paget's diseaseex in penis and scrotum underwent wide local resection in our institution. Among them, 142 patients with first-time disease and other 22 patients with recurrent disease were enrolled in this retrospective analysis.

Results:

The median duration of symptoms was much shorter in recurrent disease than in first-timers (3 vs. 24 months, P < 0.001). Patients with recurrent disease tended to have lower lesion exudation rates (27.3% vs. 51.8%, P = 0.032). In addition, patients with distant stage were more likely to obtain recurrent disease compared with first-time disease (P = 0.005). Through immunohistochemical detection of extramammary Paget's specimen, we found that HER2/neu protein expression in the recurrent group was significantly higher than first-timers (P = 0.036).

Limitations:

In this study, the information on familial history of most patients was insufficient. Moreover, due to the lack of follow-up data of our included cases, we were unable to evaluate the prognosis after diagnosis of extramammary Paget's disease.

Conclusion:

Patients with penoscrotal Paget's disease, especially those with shorter duration of symptoms, exudation of lesions, distant-stage, Paget cells infiltrating into adnexa, and HER2/neu expression, should be followed up more carefully after surgery, as they were more likely to suffer recurrence.

KEYWORDS:

Extramammary Paget's disease; HER2/neu; histology; recurrence

PMID:
31650976
DOI:
10.4103/ijdvl.IJDVL_382_18

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