Extramamm Ary Paget Disease 1 Case Report And Literature Review

Background: Eczema-like breast cancer outside(extramammary eczematoid carcinoma, EMPD) is a generally originated in the cells of apocrine duct openings, or pluripotent differentiation of malignant stromal cells within the epidermis via apocrine. As a skin cancer often visceral manifestations, can also be accompanied by sweat gland, lymphatic metastasis. Because the early clinical manifestations resemble eczema, it is misdiagnosed, the higher rate of misdiagnosis. This disease and eczema, deep mycosis, Bowen ’s disease, melanoma and other diseases. We report one case of misdiagnosis 8 years located scrotum EMPD, while the literature of the disease, treatment, diagnosis, progress, progress and other molecules to do a simple summary, the authors put forward some ideas.Case presentation: The patient, male, 67 years old, Han. Because " the scrotum repeatedly erythema, erosion, oozing with itch more than eight years,adding two years ’ treatment. After eight years in patients with no obvious incentive to sleep scrotum appear bright red rash, with itching to " eczema " treatment, be antihistamines and corticosteroids after topical creams, some rashes can be thin,faded, disabled, rash re- starting. Part may be scratching erosion, oozing, local formation of ulcers, so again, permanently. Feel scrotal skin thickening of the past 2years, and some rash invasion thickened plaque formation, the emergence of localvegetation, gradually expanding, itching, pain evident. During this period several occasions taken fungal lesions were testing and syphilis tests were negative. Outside the hospital after introduction into our department. Previously healthy, drug-free food allergies. No similar family history. Physical examination: generally good. The system checks without exception, no peripheral lymphadenopathy, no hepatosplenomegaly. Specialist examination: patients seen scrotum larger vegetation,uplift leather, light brown to brown; surface flushing, erosion, partially covered scales and crusts, ulceration, bleeding. Quality touch hard. Extended to bilateral inguinal, clear boundaries, and consciously itching, pain sensation.Histopathological examination: epidermal hypertrophy, showing Paget cell infiltration. Diffuse superficial dermal inflammatory cell infiltration.Immunohistochemistry: epidermal tumor cells CK8 / 18(+), CK5 / 6(-). Clinical,histopathological and immunohistochemical diagnosis of breast cancer outside of eczema(Paget ’s disease).Treatment: Outside the hospital for many years are " eczema " treatment,topical hydrocortisone butyrate, flufenamic acid, butyl, dehumidification itch ointment, flumetasone, Halometasone, various creams mupirocin, fusidic acid, left oral cetirizine, loratadine, epinastine, mizolastine, Dorset equality antihistamines,poor efficacy, rash delayed healing, recurrent. Fungal lesions were taken on several occasions testing and syphilis testing were negative. After diagnosis by our department, go to urology, according to the assessment after four staging of tumors identified as A2, local lesion expansion, invasion of adjacent structures( penis,perineum, testicle or spermatic cord, etc.). Patients in the urology holmium laser surgery. HE-NE laser irradiation after surgery, the wound dry. Postoperative follow-up without recurrence.Conclusion: When we report such cases to the most prompt in clinical elderly,especially in patients over the age of 50 erythema, itching, or purulent exudate, such as performance in the vulva, we should always be alert to the occurrence of breast outside paget disease, while further summarized this Caution disease after clinical diagnosis, and treatment of various diseases, to make elaborate, as well as thetreatment of this disease advantages and disadvantages, indications, and also all kinds of literature review of the treatment of this disease the relapse rate compared summarized.