[Clinicopathologic study of 11 patients with Paget's disease of scrotum].

OBJECTIVE

To probe the relationship of clinicopathologic presentations and prognosis of Paget's disease primarily involving the scrotum.

METHODS

11 cases of scrotal Paget's disease were studied retrospectively from 1984 to 1997. PAS was stained and EMA, S-100, HMB45, CEA and CA15-3 were immunostained in all cases for the differential diagnosis from Bowen's disease and malignant melanoma.

RESULTS

Six of 11 cases involved hair follicle and/or sweat glands, and 3 cases involved dermis (one had metastasis of left superficial and deep inguinal lymph nodes, and left internal iliac lymph nodes). Paget's cells were positive for PAS (11/11), EMA (11/11), CEA (6/11), CA15-3 (11/11), and negative for S-100, HMB45. Wide local excision of the lesions was performed in 10 of 11 patients both for primary disease and recurrent disease. 3 of the 10 patients underwent lymph nodes resection and metastasis was found in 1 case pathologically. One patient accepted chemotherapy and died, from respiratory insufficiency after one month. The other 10 patients were followed up for 6 to 127 months and no patient died of Paget's disease.

CONCLUSIONS

Involvement of hair follicles and sweat glands by Paget's cell does not influence the prognosis.However, invasion of dermis by Paget's cells may suggest possible metastasis.