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Extramammary Paget's Disease

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Li Liu, MD
Last Modified: November 1, 2001

Dear OncoLink "Ask the Experts,"
My father was recently diagnosed with Paget's disease of the scrotum. What are the treatment options for this disease?  
Thank you very much.
S

Li Liu, MD, OncoLink editorial assistant, responds:

Dear S,
Thank you for your interest and question.

Paget's disease is a relatively rare disease which occurs more frequently on the areola and nipple (mammary Paget's disease) and much less commonly on the vulva, scrotum, or perineal and perianal areas (extramammary Paget's disease). Extramammary Paget's disease is a rare form of adenocarcinoma. The lesions appear as a solitary, well-defined patch with an eczematous surface. It looks similar to psoriasis and eczematous dermatosis (eczema). Scrotal Paget's disease is a very uncommon clinical entity. Wide local excision or Mohs micrographic surgery with or without subsequent radiation therapy has been used in most of the reported cases (British Journal of Urology 1996 May;77(5):758-60). Depending on the area involved and the extension of surgery, a split skin graft may be necessary (Annals of Plastic Surgery. 23(2):141-6, 1989 Aug). Laser therapy can also be used in selected cases (Journal of Urologie (Paris) 1993;99(5):269-71).

You should consider discussing your father's case with a surgeon as well as a radiation oncologist.