Ann Dermatol.  2013 Feb;25(1):88-91. 10.5021/ad.2013.25.1.88.

Extramammary Paget's Disease of External Genitalia with Bowenoid Features

• Chung J
• Kim JY
• Gye J
• Namkoong S
• Hong SP
• Park BC
• Kim MH

• KMID: 2265977
• DOI: http://doi.org/10.5021/ad.2013.25.1.88

Abstract

Extramammary Paget's disease (EMPD) is an uncommon intraepithelial adenocarcinoma, primarily affecting the apocrine-bearing skin. Bowen disease is an intraepithelial squamous cell carcinoma having the potential to become invasive carcinoma. The histopathological concomitant features between EMPD and Bowen disease have been described. One theory is that primary EMPD arises multicentrically, within the epidermis from the pluripotent stem cells. Herein, we describe a case of EMPD that had bowenoid features, and review the previous cases associated with the origin of EMPD.

Keyword

Bowen's disease; Extramammary Paget's disease; Male genitalia

MeSH Terms

Adenocarcinoma
Bowen's Disease
Carcinoma, Squamous Cell
Epidermis
Genitalia
Genitalia, Male
Male
Paget Disease, Extramammary
Pluripotent Stem Cells
Skin

Figure

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  Fig. 1 Oozing erythematous patch with solitary moist nodule on external genitalia. Inguinal hernia is seen.

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  Fig. 2 (A) Pagetoid spreading large, round cells are in the thickened epidermis, scattered discretely or grouped forming nest (H&E, ×40). (B) Pagetoid cells have large nucleus and pale cytoplasm, and intercellular bridges are not seen. Basal cells beneath these cells are somewhat flattened (H&E, ×400). (C~F) Immunohistochemical staining of Paget cells (C: CEA, D: CK7, E: CAM5.2, F: P63; ×100).

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  Fig. 3 (A) Irregularly thickened epidermis has cells lying in complete disorder result in 'windblown' appearance (H&E, ×40). (B) Highly atypical cells showing large, hyperchromatic and pleomorphic nuclei are seen. Some of them showed atypical individual cell keratinization (H&E, ×400). (C~F) Immunohistochemical staining for atypical cells (C: CEA, D: CK7, E: CAM5.2, F: P63; ×100).

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