Vulvar Adenocarcinoma With Pagetoid Spread: A Case Report

IF 1.5 Q4 ONCOLOGY

Cancer reports Pub Date : 2025-06-04 DOI:10.1002/cnr2.70241

Kazuaki Nishimura, Seiji Kagami, Haruka Kajio, Tamaki Wada, Naoyuki Toki, Kiyoshi Yoshino

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Abstract

Background

In rare cases, cancer cells adjacent to the skin migrate intraepithelially and reach the epidermis, presenting a histological appearance similar to that of Paget's disease; this phenomenon is termed pagetoid spread. Herein, we report a case of vulvar adenocarcinoma with pagetoid spread, in which the primary lesion could not be identified outside the vulva.

Case

An 84-year-old woman, presented with a 5-cm tumor in the right vulva. Histopathological examination revealed atypical Paget cells. Immunohistochemical examination revealed that the cells were positive for CK20 and CK7 and negative for CDX2 and GCDFP15. Thus, it was determined that the tumor was not a primary extramammary Paget's disease, but a secondary extramammary Paget's disease with pagetoid spread. There were no masses in the anus, rectum, urinary tract, or vagina. Computed tomography scan revealed a right vulvar tumor and lymph node enlargement around the abdominal aorta, and the tumor was diagnosed as lymph node metastasis of vulvar adenocarcinoma associated with extramammary Paget's disease.

Conclusion

We report a rare case of vulvar adenocarcinoma with pagetoid spread.

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外阴腺癌伴页状扩散1例

在少数病例中，邻近皮肤的癌细胞在上皮内迁移并到达表皮，呈现与Paget病相似的组织学外观；这种现象被称为页状传播。在此，我们报告一例外阴腺癌伴页状扩散，其原发病灶无法在外阴外发现。病例84岁女性，右外阴5公分肿瘤。组织病理学检查显示非典型Paget细胞。免疫组化检查显示细胞CK20和CK7阳性，CDX2和GCDFP15阴性。因此，确定肿瘤不是原发性乳腺外佩吉特病，而是继发性乳腺外佩吉特病伴页状扩散。肛门、直肠、泌尿道和阴道均未见肿块。ct示右外阴肿瘤，腹主动脉周围淋巴结肿大，诊断为外阴腺癌伴乳腺外佩吉特病淋巴结转移。结论我们报告一例罕见的外阴腺癌伴页状扩散。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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