乳房外 Paget 病の診断と治療

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Clinical aspects of extramammary Paget's disease are reviewed, based on the author's experience of 109 cases. Statistically, male to female ratio is nearly 2:1, the average age of the patient is 66 years. Associated malignancies are found in 15 cases, which comprises 13.8% of the cases. 33 cases had developed to be the invasive carcinoma, among which 13 cases had the lymph node involvement histiologically. In these metastatic cases, those who had bilateral inguinal nodes metastases died of the disease. Histological feature of the early invasive carcinoma is charaterized by the direct tumor invassion from the surface epidrmis, not from the adnexal structures. As for the sites of occurrence, 104 on the genital area (including 2 cases of so called triple Paget's disease and one case of double Paget's disease), 4 on the axilla (including 2 cases of triple and one case of double Paget's disease), 3 on the anal region, one on the abdomen. Discusson about the surgical treatment includes the indication of operation, preoperative preparations, surgical margin of the excision, the actual procedures and the postoperative complications. As to the histogenesis of the tumor cells, multicentric occurrence from surface epidermis is suggested from clinical and histological observation.

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