抗アンドロゲン療法を行った進行期の肛囲バジェット病の1例
2003 年 18 巻 2 号 p. 179-183
詳細
2003 年 18 巻 2 号 p. 179-183
We reported a 59-year-old male with recurrent Paget's disease in the anal region associated with metastasis to the groin and iliac lymphnodes. After surgical excision, he had received radiation therapy and low dose FP chemotherapy. After he had received three courses of low dose FP chemotherapy, CT examination revealed para-aortic lymph node swelling. We thought they possibly were metastasized lymph nodes.
Immunohistological study showed androgen receptors and erbB2 oncogene on metastatic tumor cells of the iliac lymphnodes. Anti-androgen therapy is effective against extramammary Paget's disease. We conducted anti-androgen therapy on this case. It was reported that erbB2 oncogene was related with a bad prognosis. So at first we speculated a poor prognosis of this case. For the following 1 year after this therapy, no recurrence of tumor or visceral metastasis was found. We thought the tumor was in a dormant state, though the value of serum CEA gradually increased.
This case had p53 variated oncogene, although this oncogene was unusually manifested on cells of extramammary Paget's disease. We initially considered this case as Extramammary Paget's disease. More immunohistochemical examination revealed cytokeratin 7 and 20 antigen on the metastatic tumor's cells. This finding suggested that it was the pagetoid phenomenon arising from the adenocarcinoma in the anal region.
Further observation and accumulation of the cases treated with anti-androgen therapy were warranted. [Skin Cancer (Japan) 2003; 18: 179-183]
