Case Number : CT0121 Adam_Bates

Extramammary Paget s disease- epidermotropic metastasis from a carcinoma of prostate
 

Epidermotropic spread from underlying adenocarcinoma. Agreed that in a male prostratic Ca. has to be considered but need a wide immunopanel (CEA/ EMA to confirm, p63, CK 5, 7, 20, CDX2, PSA, TTF1, etc)
 

Extramammary Paget's diease, secondry to an adenocarcinoma. A panel of IHC and a relevant clinical history are essential for the diagnosis of the primary.
 

Agree with A Z. Extramammary Pagets vs Pagets disease of male breast. Site, history and perhaps IHC are important in sorting this out.
 

I feel that compression of basal keratinoyctes is diagnostic of (extra)mammary Paget with underlying dermal invasion of the tumour.. CK 7, 20 (sometimes indicating internal malignancy) and CEA may be very helpful.
 

Epidermotropic metastatic adenocarcinoma.
 

I now recognized that signet-ring cell appearance in fig 4 militates against the mammary version of Paget disease, thus making the extramammary form likely..
 

? Extramammary Paget's

Thank you all for your comments and sorry for the delay in posting the final diagnosis, which in this case was apocrine carcinoma.