Case Number : Case 243 Posted By: Guest

rolando espinoza - particular (ecuador) Wrote:

paget extramamaria

Submitted on 17/05/2011 10:55
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Phillip McKee - Overseas Consultations (Arizona, USA) Wrote:

The diagnosis is Extra-mammary Paget's disease. In some areas you can see the basal keratinocytes below the Paget's cells. Well done to all those who posted and thank you Richard for posting your comments on the connective tissue naevus case. Next case tomorrow.

Submitted on 16/05/2011 17:30
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Francisco Vilchez - Department of Dermatology. Virgen de la Victoria Clinical Universitary Hospital. (Málaga (Spain)) Wrote:

I bet Paget disease.

Submitted on 16/05/2011 15:15
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Eman El-Nabarawy - Cairo University (Egypt) Wrote:

Extramammary Paget's disease.

Submitted on 16/05/2011 12:33
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Richard Carr - Warwick (UK) Wrote:

I posted a comment on the connective tissue naevus case (not overly helpful I must admit - but bascially it fitted with the clinical diagnosis). ON this case I favour paget's/EMP. Our panel is, Alcian blue/DPAS, BerEP4 (all Pagets/EMP); Cam5.2 (all Paget's/EMP but neg in pagetoid Bowen's and melanoma); S100 (for melanoma with other markes neg.) For EMP would do CK7/CK20 (secondary urothelial is CK20 +ve as is rectal adenocarcinoma. Primary EMP of vulva and anus can be CK7+ and CK20+ especially apocrine). Extrammary Paget’s: CK7-/CK20+ phenotype would suggest rectal tumour in perianal/perineal disease. You can also get intra-epidermal Merkel cell carcinomas and need to consider in the differential of pagetoid lesions (but not this case).

Submitted on 16/05/2011 09:59
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Marcela Saeb Lima - Instituto Nacional de Ciencias Medias y Nutricion Salvador Zubiran (Mexico City) Wrote:

I would go for the differential: melanoma, SCC, sebaceous carcinoma, Paget´s, and ask for inmunohistochemistry EMA, CAM 5.2, melan A

Submitted on 16/05/2011 09:17
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Mona Abdel Halim - Dermatology Department, Faculty of medicine, Cairo University (Egypt) Wrote:

Intraepidermal proliferation of atypical epithelioid large cells with ample cytoplasm and prominent nuclei, some show intracytoplasmic lumina..Few cells are showing pagetoid spread, Will go for Extramammary Paget's disease..

Submitted on 15/05/2011 17:51
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