Genital Paget's disease in a man.

Pagetoid cells are large intraepidermal cells which spread intraepidermally. We report a 67-year old Caucasian male, who presented for the first time in 1993 with a long-standing pruritic lesion at the scrotum. He was treated for several years by antiinflammatory ointments. Only in July 2003 was a biopsy taken for the first time. The histopathological evaluation revealed the diagnosis of an extramammary Paget's disease (EMPD). Pagetoid cells are large intraepidermal cells with a large nucleus and ample cytoplasm. EMPD consists of primary malignant cells of epidermal origin, but in rare cases, pagetoid cells may also originate from carcinomas with epidermotropic growth. EMPD is a slowly progressing disease, but invading and metastasing tumors may also develop. Considering the good prognosis with long-term survival, nonsurgical modalities should be considered as primary treatment for noninvasive EMPD.