Abstract
The efficacy of neoadjuvant therapy, in addition to adjuvant chemotherapy, for extramammary Paget's disease (EMPD) has not been widely investigated. Here, we report a case of advanced EMPD that was successfully treated with surgical resection and docetaxel chemotherapy after normalization of serum CEA levels using neoadjuvant therapy. A 70-year-old man presented with decolorized or faint erythematous multiple plaques on his scrotum and penis. His serum CEA levels were markedly elevated. Clinical and imaging examinations showed no evidence of visceral or lymphatic metastases, but biopsied lymph nodes from both inguinal lesions showed clear metastases. Three courses of neoadjuvant chemotherapy with docetaxel resulted in normalization of serum CEA. Wide tumor resection and bilateral groin dissection were then performed. Histopathological findings for the skin lesion revealed intraepidermal Pagetoid proliferation of tumor cells together with partial dermal invasion. Metastases were detected in most of the inguinal lymph nodes up to the right Cloquet's node. Several courses of adjuvant chemotherapy with docetaxel were administered and one year later no metastasis or visceral involvement was detected. Therefore, our results suggest that neoadjuvant and adjuvant chemotherapy with docetaxel is helpful for treatment of advanced EMPD.[Skin Cancer (Japan) 2012 ; 27 : 93-97]
