Extramammary Paget's disease of penis and scrotum.
OBJECTIVE
To make clear the uncertainty of the clinical outcome of extramammary Paget's disease (EMPD). Penile and scrotal involvement of EMPD is exceedingly rare, and only small series or case reports have been reported.


METHODS
From 1995 to 2003, 36 patients with penile and scrotal EMPD were treated and followed up. Local wide excision was done in all patients with or without intraoperative frozen biopsy analysis.


RESULTS
Of the 36 patients, 13 (36.1%) underwent intraoperative frozen biopsy analysis and only 1 patient (7.7%) had a positive surgical margin. However, 23 (63.9%) underwent local wide excision with excessive surgical margins of up to 1 to 2 cm only by gross examination, but 17 (73.9%) of them had positive surgical margins (P <0.01). Of the 17 patients with positive surgical margins, 8 developed local recurrence at a median of 8 months of follow-up (P <0.05). One patient who had invasion to the subcutaneous tissue died of metastatic EMPD and internal malignancy (renal cell carcinoma) at 17 months after the initial operation. No patient had underlying adnexal carcinoma.


CONCLUSIONS
The results of our study indicate that local wide excision with intraoperative frozen biopsy analysis is essential to the complete treatment of EMPD.
Yang
Won Jae
WJ
Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea.
Kim
Dong Suk
DS
Im
Young Jae
YJ
Cho
Kang Su
KS
Rha
Koon Ho
KH
Cho
Nam Hoon
NH
Choi
Young Deuk
YD
D000368:Aged; D005834:Genital Neoplasms, Male / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010145:Paget Disease, Extramammary / Q000175:diagnosis / Q000556:secondary / Q000601:surgery*; D010412:Penile Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D012611:Scrotum