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JOURNAL OF CLINICAL OBSTETRICS & GYNECOLOGY, vol.20, no.6, pp.411-414, 2010 (Peer-Reviewed Journal)
A 53-year-old woman presented with an 18 x 7cm sized eczematoid red lesion involving bilateral labia major, vulva and clitoris. Pathologic examination of biopsy material revealed vulvar adenocarcinoma associated with Paget’s disease. Secondary malignancies were ruled out after a
systemic evaluation. Radical vulvectomy with bilateral lymphadenectomy was performed. Histopathological examination confirmed Paget’s disease with underlying adenocarcinoma. Lymph node metastasis was present and there was a microscopic focus of Paget’s located at 5 mm distance from
the excisional margin. A total dose of 55 gray radiotherpay was administered postoperatively to reduce the risk of recurrence The patient has been disease-free for 5 years. Location, depth of dermal
invasion, tumor size and lymph node metastasis are important prognostic factors in Paget’s disease. Current standart of care is radical vulvectomy with bilateral lymphadenectomy. Postoperative
radiotherapy is indicated to reduce the risk of recurrence in cases with positive surgical margins.
Key Words: Paget’s disease, extramammary; vulvar neoplasms
Turkiye Klinikleri J Gynecol Obst 2010;20(6):411-