2017 Volume 66 Issue 3 Pages 195-199
We report herein the case of invasive perianal Paget’s disease. An 8X-year-old man suffered from the eruption with itching of perianal region. He treated with ointment medicines at a dermatologic clinic. The symptom was not improved and the clinic doctor performed the biopsy of the eruption. Skin biopsy revealed Paget cells. The patient was admitted to our hospital. Imaging examinations could not detect any sign of rectal and anal cancers. Abdominoperineal resection was performed because of the long infiltration of Paget’s cell in the rectal mucosa. Histological examination of the resected specimen revealed proliferation of Paget cells, but no evidence of primary anorectal cancer was found. Although immunohistochemical findings were not typical, the final pathologic diagnosis was primary invasive perianal Paget’s disease. Both immunohistochemical findings and detection of nearby occult cancers are necessary to diagnose between perianal Paget’s disease and Pagetoid spread. Sometimes, it is difficult to differentiate two diseases in preoperative examinations.
