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A case of invasive perianal paget’s disease mimicking pagetoid spread of internal malignancy

山口医学 Volume 66 Issue 3 Page 195-199
published_at 2017-08-01
B030066000307.pdf
[fulltext] 1.13 MB
Title
内臓癌のPaget現象と鑑別困難であった肛門周囲Paget病の1例
A case of invasive perianal paget’s disease mimicking pagetoid spread of internal malignancy
Creators Yano Yuka
Creators Kuga Takayuki
Creators Sano Fumiho
Creators Ueda Koushiro
Creators Inokuchi Toshihiro
Creators Fujii Yasuhiro
Source Identifiers
Creator Keywords
乳房外Paget病 肛門周囲Paget癌 Paget現象 免疫組織化学検査
症例は8X歳男性.X年春より肛門部の湿疹と掻痒感を自覚していた.近医皮膚科で外用剤療法を受けていたが改善せず,同医院で生検を受け,Paget細胞を認め,X+1年Y月当科に紹介された.術前検査で隣接臓器癌は認めなかったが,術中所見で内臓癌によるPaget現象が疑われ,腹会陰式直腸切断術を施行した.術後の免疫組織学的検査はPaget現象のパターンであったが,切除標本内に明らかな内臓癌はなく最終的な病理学的診断は肛門周囲Paget病であった.術後経過良好で,術後約6年現在無再発で日常生活に支障を認めていない.
We report herein the case of invasive perianal Paget’s disease. An 8X-year-old man suffered from the eruption with itching of perianal region. He treated with ointment medicines at a dermatologic clinic. The symptom was not improved and the clinic doctor performed the biopsy of the eruption. Skin biopsy revealed Paget cells. The patient was admitted to our hospital. Imaging examinations could not detect any sign of rectal and anal cancers. Abdominoperineal resection was performed because of the long infiltration of Paget’s cell in the rectal mucosa. Histological examination of the resected specimen revealed proliferation of Paget cells, but no evidence of primary anorectal cancer was found. Although immunohistochemical findings were not typical, the final pathologic diagnosis was primary invasive perianal Paget’s disease.Both immunohistochemical findings and detection of nearby occult cancers are necessary to diagnose between perianal Paget’s disease and Pagetoid spread. Sometimes, it is difficult to differentiate two diseases in preoperative examinations.
Subjects
医学 ( Other)
Languages jpn
Resource Type journal article
Publishers 山口大学医学会
Date Issued 2017-08-01
File Version Version of Record
Access Rights open access
Relations
[ISSN]0513-1731
[NCID]AN00243156
Schools 医学部附属病院