伴表皮下浸润性癌的外阴Paget病1例并文献复习  

Vulvar Paget's disease with subcutaneous invasive carcinoma: A case report and literature review

作　　者：王晨晨 陈汝蕾 吕京澴[1] WANG Chenchen;CHEN Rulei;Lü Jinghuan(Department of Pathology, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou Jiangsu 215002, China)

机构地区：[1]南京医科大学附属苏州医院,苏州市立医院病理科,江苏苏州215002

出　　处：《临床与病理杂志》2018年第12期2743-2748,共6页Journal of Clinical and Pathological Research

摘　　要：外阴Paget病是一种少见恶性肿瘤,多见于绝经后白人女性,预后较差。本文报道1例74岁绝经后女性,因自觉外阴瘙痒入院,妇检示:左侧大阴唇内侧肿块,约3cm×2cm。患者行外阴包块扩大切除术,术后病理诊断为外阴Paget病合并表皮下浸润性癌,临床分期为外阴癌IA期。11个月后,患者左腹股沟淋巴结肿大,术后病理诊断为转移性肿瘤(外阴腺癌)。患者后续未作辅助治疗,随访2.5个月无复发。目前手术是治疗外阴Paget病的首选方法,考虑到术后复发率高,建议密切随访。对于皮下浸润的患者,应考虑化疗或局部放疗。Primary cutaneous Paget’s disease is a rare malignant tumor that occurs in postmenopausal white women and has a poor prognosis. A 74-year-old postmenopausal woman was admitted to the hospital with pruritus vulvae. The gynecological examination showed that the medial mass of the left labia majora with 3 cm × 2 cm. The patient underwent extended excision of vulva masses. Postoperative pathological diagnosis was vulvar Paget’s disease with subcutaneous invasive carcinoma. The clinical stage was IA stage of vulvar carcinoma. Eleven months later, the patient had enlarged left inguinal lymph nodes and was pathologically diagnosed as a metastatic tumor (vulvar adenocarcinoma). Patients were followed up for 2.5 months without adjuvant therapy. Currently, surgery is the first choice for vulvar Paget’s disease. Considering the high recurrence rate, close follow-up is recommended. For patients with subcutaneous infiltration, chemotherapy or local radiotherapy should be considered.

关 键 词：外阴PAGET病 浸润性癌 治疗 预后 

分 类 号：R737.35[医药卫生—肿瘤]