Radiotherapy for Perianal Extramammary Paget's Disease: A case report

Abstract

Extramammary Paget\'s disease (EMPD) is a rare, usually non-invasive intraepithelial skin adenocarcinoma which predominantly involves vulvar, perianal, scrotal and penile skin. Management of EMPD is rather complicated due to multifocal involvement, lack of clear tumor boundaries and clinically occult extensions. High recurrence rates following surgery together with the goal of achieving a better cosmetic and functional outcome have prompted the utilization of non-surgical treatment modalities in the management of EMPD. Radiotherapy may either be used as adjunct to surgery after recurrence or may be employed in the treatment of patients with high risk of local failure after surgery. 76-year-old male patient was admitted to Gulhane Military Medical Academy with the complaints of persistent anal itching. He was diagnosed with perianal Paget’s disease after consecutive skin biopsies. The patient was deemed unsuitable for surgery due to external anal sphincter involvement which was detected by endoanal ultrasonography and he was treated with curative radiotherapy in our department. We reviewed the pertinent literature, and discussed treatment options and outcomes. In conclusion, we recommend radiotherapy as a treatment option for patients with perianal Paget’s disease with curative intent.