title: Extensive invasive extramammary Paget disease evaluated by F-18 FDG PET/CT: a case report.
abstract: Extramammary Paget disease (EMPD) is a rare cutaneous, intraepithelial adenocarcinoma. Because of its rarity, little is known about the value of fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) in evaluating this disease. Our case report aims to increase current knowledge of FDG PET/CT in EMPD as a noninvasive imaging tool for assessing the extension of the disease and detecting distant metastases.We reported a 64-year-old Chinese man who presented with a slowly progressive, ill-margined erythematous lesion with a crusted, eroded, and scaly surface involving multiple sites of penis, scrotum, left pelvic wall, hip, groin, and thigh for >4 years, which became extensive in the past 1 year. He was referred for an FDG PET/CT examination to further evaluate the lesions. A following skin biopsy was performed to obtain a definitive histological diagnosis.FDG PET/CT imaging revealed mild FDG uptake at the extensive cutaneous lesion with subcutaneous invasion, involvement of lymph nodes, and multiple intense FDG-avid of skeletal metastases. According to the appearance of FDG PET/CT, a provisional diagnosis of advanced cutaneous malignancy was made. Histopathology findings indicated characteristic of EMPD. The patient was treated with radiation therapy and died from complications 2 months after the last dose of radiotherapy.Our case highlighted that a whole-body FDG PET/CT should be incorporated into the diagnostic algorithm of EMPD to give a comprehensive assessment of this disease.
authors.affiliation: From the Department of Nuclear Medicine (Z-GL); and Department of Pathology (X-JQ), Pingjin Hospital, Logistics University of Chinese People's Armed Police Force, Tianjin, China.
authors.forename: Zu-Gui
authors.initials: ZG
authors.lastname: Li
authors.forename: Xiao-Jing
authors.initials: XJ
authors.lastname: Qin
mesh_terms: D000230:Adenocarcinoma / Q000000981:diagnostic imaging* / Q000532:radiotherapy; D017809:Fatal Outcome; D019788:Fluorodeoxyglucose F18; D006119:Groin; D006615:Hip; D006801:Humans; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis / Q000000981:diagnostic imaging* / Q000532:radiotherapy; D010145:Paget Disease, Extramammary / Q000000981:diagnostic imaging* / Q000532:radiotherapy; D010413:Penis; D049268:Positron-Emission Tomography; D011878:Radiotherapy; D012611:Scrotum; D012878:Skin Neoplasms / Q000000981:diagnostic imaging* / Q000532:radiotherapy; D013848:Thigh; D014057:Tomography, X-Ray Computed
chemical_list: D019788:Fluorodeoxyglucose F18