Case Number : Case 2791- 18 March 2021 Posted By: Saleem Taibjee

Adenocarcinoma with Pagetoid spread.

Squamosus cell non-keratizing invasive carcinoma .

EMPD-associated Apocrine Adenocarcinoma, with vascular invasion. 

Apocrine adenocarcinoma with pagetoid spread

apocrine adenocarcinoma with pagetoid spread

Apocrine Adenocarcinoma

This is a case of primary, invasive, extramammary Paget's, courtesy of my colleague Mohamed Satti.

It is a challenging case in so far as the intraepidermal component is so florid that at first sight one might not appreciate the Pagetoid nature of a subpopulation of cells distinct to the resident keratinocytes, with a potential misdiagnosis as squamous cell carcinoma / adenosquamous carcinoma. We nearly fell into this trap.

Various immunostains were performed, mainly in excluding secondary causes (from an internal malignancy). Positive staining included: CK7, BerEP4, GATA3, GCFDP15, CEA, Her2. Negative stains included CK20, CDX2, ER, PR, PAX8.

BW

Saleem

Thanks for the illustrative case.