エトポシド少量投与が奏効した乳房外Paget病の1例

抄録

We report a case of extramammary Paget's disease in which metastatic skin lesions were treated successfully with low-dose Etoposide administered orally over a 12-week period. The patient, an 84-year-old male, visited us because of a tumor and erythema of the scrotum in June 2000. At presentation, he had a tumor measuring 56×30mm on the scrotum and erythema measuring 12×7cm around the tumor. ACT scan revealed swollen lymph nodes in the bilateral groin. Surgery and lymph node biopsy were carried out in July 2000. Infiltration of tumor cells was revealed microscopically in the bilateral inguinal lymph nodes. Metastatic skin lesions developed on the abdomen two months after the operation, but the tumors regressed gradually and disappeared seven weeks after the introduction of oral low-dose Etoposide (25mg/day) in October 2000. The serum level of carcinoembryonic antigen (CEA) decreased and was normalized 12 weeks after the start of administration. Because of the onset of interstitial pneumonia, administration of Etoposide was stopped in December 2000.
Although Etretinate was introduced after the pneumonia was resolved by steroid pulse therapy, metastatic skin lesions gradually developed and the patient died 11 months after the operation. Although Etoposide caused interstitial pneumonia in this patient, we conclude that its oral long-term use at a low dose is worth considering in patients with advanced extramammary Paget's disease. [Skin Cancer (Japan) 2001; 16: 376-381]