title: Extramammary Paget's disease/carcinoma successfully treated with a combination chemotherapy: report of two cases.
abstract: We have treated two patients with extramammary Paget's disease/carcinoma (EMPD/C), a 62-year-old woman and a 78-year-old man. In both patients, lymph nodes in the areas of the bilateral inguinal, external iliac arteries, and abdominal aorta were affected. After surgery, they underwent 5 courses of systemic combination chemotherapy at 4-week intervals to residual or recurrent lymph node metastasis. Each course consisted of 3.5 mg mitomycin C and 50 mg epirubicin (day 1), 0.6 mg vincristine (days 1 and 7), 30 mg cisplatin (days 1, 2, and 3), and 350 mg 5-fluorouracil (days 3, 4, 5, 6, and 7). The affected lymph nodes in both patients subsided in response to the chemotherapy. Positron emission tomography (PET) scans confirmed the complete remission of lymph node metastasis in Case 1. In Case 2, they were reduced by more than 90% on computed tomography (CT) scans. Adverse effects included leukocytopenia, vomiting, hypesthesia, and constipation, all of which disappeared after the completion of chemotherapy. While surgery with wide local excision is the treatment of choice in patients with EMPD/C, there is currently no standardized treatment for advanced cases with metastasis. We describe two patients with EMPD/C whose metastatic lesions responded well to this combination of chemotherapy.
authors.affiliation: Department of Dermatology, Kagoshima University Graduate School of Medical and Dental Sciences, Sakuragaoka, Kagoshima, Japan.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Mochitomi
authors.forename: Ryoko
authors.initials: R
authors.lastname: Sakamoto
authors.forename: Akira
authors.initials: A
authors.lastname: Gushi
authors.forename: Takaki
authors.initials: T
authors.lastname: Hashiguchi
authors.forename: Kentaro
authors.initials: K
authors.lastname: Mera
authors.forename: Shigeto
authors.initials: S
authors.lastname: Matsushita
authors.forename: Masayuki
authors.initials: M
authors.lastname: Nishi
authors.forename: Tamotsu
authors.initials: T
authors.lastname: Kanzaki
authors.forename: Takuro
authors.initials: T
authors.lastname: Kanekura
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D003131:Combined Modality Therapy; D003937:Diagnosis, Differential; D005260:Female; D006119:Groin; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D010145:Paget Disease, Extramammary / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy; D010502:Perineum; D012878:Skin Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy; D014057:Tomography, X-Ray Computed