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Frozen section-guided wide local excision in the treatment of penoscrotal extramammary Paget's disease.

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  • المؤلفون: Zhu Y;Zhu Y; Ye DW; Chen ZW; Zhang SL; Qin XJ
  • المصدر:
    BJU international [BJU Int] 2007 Dec; Vol. 100 (6), pp. 1282-7. Date of Electronic Publication: 2007 Sep 10.
  • نوع النشر :
    Journal Article
  • اللغة:
    English
  • معلومة اضافية
    • المصدر:
      Publisher: Blackwell Science Country of Publication: England NLM ID: 100886721 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1464-410X (Electronic) Linking ISSN: 14644096 NLM ISO Abbreviation: BJU Int Subsets: MEDLINE
    • بيانات النشر:
      Original Publication: Oxford, UK : Blackwell Science, c1999-
    • الموضوع:
      Paget Disease, Extramammary/*surgery ; Penile Neoplasms/*surgery ; Scrotum/*surgery; Aged ; Aged, 80 and over ; False Positive Reactions ; Frozen Sections ; Humans ; Male ; Middle Aged ; Neoplasm Invasiveness ; Neoplasm Recurrence, Local ; Paget Disease, Extramammary/pathology ; Penile Neoplasms/pathology ; Prognosis ; Scrotum/pathology ; Treatment Outcome
    • نبذة مختصرة :
      Objective: To analyse the clinicopathological characteristics of penoscrotal extramammary Paget's disease (EMPD) and to discuss the outcomes after frozen section-guided wide local excision.
      Patients and Methods: From 1990 to 2005, at our institution, 38 patients with penoscrotal EMPD received wide local excision with intraoperative frozen-section analysis. Their medical records were reviewed for patient demographics, lesion characteristics, surgical margin status, and clinical outcome.
      Results: No patients had EMPD secondary to a non-cutaneous malignancy; 23 patients had intraepithelial EMPD, 12 had invasive EMPD and three had EMPD with underlying adnexal adenocarcinoma. The median (range) largest diameter of the lesion was 6 (1-20) cm. Of 38 patients, 12 (32%) had positive frozen-section results and had extended surgical excision until a negative margin was obtained. Additional margin examination of the gross specimen and final examination of the frozen sections showed that five patients had false-negative results. There was a microscopic positive margin in 15 of 38 (40%) patients when a conventional 2 cm clinical tumour-free border was maintained. Skin erythematous patches were significantly correlated with the spread of disease (P = 0.03). After a median (range) follow-up of 33.5 (3-140) months, six of 38 (16%) patients had recurrent disease, of whom only two had recurrent skin lesions, while four had systemic progression.
      Conclusion: Frozen section-guided wide local excision gave an acceptable recurrence rate in the treatment of penoscrotal EMPD. Primary EMPD with dermal invasion should be actively monitored for possible aggressive behaviour.
    • الموضوع:
      Date Created: 20070914 Date Completed: 20080103 Latest Revision: 20101118
    • الموضوع:
      20231215
    • الرقم المعرف:
      10.1111/j.1464-410X.2007.07188.x
    • الرقم المعرف:
      17850363