Cytologic detection of recurrence in extramammary Paget's disease of the vulva: a report of two cases.
BACKGROUND
Extramammary Paget's disease of the vulva (EMPDV) is a rare gynecologic malignancy. We examined two cases of EMPDV in which cytologic study led to early detection of disease recurrence.


METHODS
In case 1, a 71-year-old woman, recurrence was detected with malignant cells from the vaginal Papanicolaou smear a few months after radical surgery for endometrial cancer. An asymptomatic perineal erythematous lesion was identified and diagnosed as EMPDV by biopsy specimen. She underwent curative surgery, but during the follow-up period, malignant cells appeared again in her vaginal Papanicolaou smear, which led to early detection of the recurrent disease that was macroscopically invisible. In case 2, an 80-year-old woman presented with the complaint of perineal pruritus and was diagnosed with EMPDV. Twenty-two months after the curative primary surgery, bilateral groin lymphadenopathies appeared, and the cytologic specimen by fine needle aspiration biopsy from the lymph nodes led to early detection of the recurrence without her experiencing negative side effects such as severe pain.


CONCLUSIONS
Cytologic examination is a simple but efficient diagnostic measure without major negative side effects, provided the procedures are applied adequately and performed correctly.
Department of Obstetrics and Gynecology, International University of Health and Welfare, Atami Hospital, Atami City, Shizuoka, Japan. yk98tnk@yahoo.co.jp
Yaku
Y
Tanaka
Toshinori
T
Kirihara
Hajime
H
Kitamura
Manabu
M
Kuriyama
Hiromasa
H
Hori
Itsuo
I
Gorai
D000368:Aged; D000369:Aged, 80 and over; D044963:Biopsy, Fine-Needle; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D010145:Paget Disease, Extramammary / Q000175:diagnosis* / Q000473:pathology* / Q000601:surgery; D065006:Papanicolaou Test; D012008:Recurrence; D014626:Vaginal Smears; D014844:Vulva / Q000473:pathology* / Q000601:surgery; D014846:Vulvar Neoplasms / Q000175:diagnosis* / Q000473:pathology* / Q000601:surgery