Chronic Vulvar Paget’s Disease: A Therapeutic Challenge with a Review of the Literature

Malek, Bouhani; Ines, Zemni; Yasmine, Fertani; Hatem, Bouzaiene; Khaled, Rahal

doi:10.22543/7674.62.P356360

Open AccessCase Report

Chronic Vulvar Paget’s Disease: A Therapeutic Challenge with a Review of the Literature

by

Bouhani Malek

^*,

Zemni Ines

,

Fertani Yasmine

,

Bouzaiene Hatem

and

Rahal Khaled

Department of Oncologic Surgery, Salah Azaiz Institute, Boulevard 9th April, Tunis 1009, Tunisia

^*

Author to whom correspondence should be addressed.

J. Mind Med. Sci. 2019, 6(2), 356-360; https://doi.org/10.22543/7674.62.P356360

Submission received: 12 August 2019 / Revised: 16 September 2019 / Accepted: 16 September 2019 / Published: 9 October 2019

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Highlights

Vulvar Paget’s disease is a therapeutic challenge for physicians due to its chronicity and its high rate of recurrence. The management of local recurrence is associated with mutilating surgery.
Currently, new conservative approaches such as local cream use, laser therapy, and many other treatments are being adopted. Imiquimod 5% cream is an alternative for consideration in the case of invaded margins.

Abstract

Vulvar Paget’s disease is an uncommon adenocarcinoma of the female genital tract, occuring more often in postmenopausal Caucasian women and accounting for 1–2% of all vulvar malignancies. A 39-year-old female patient was examined for the erythematous and pruritic vulvar lesion, with biopsy and histological examination revealing vulvar Paget’s disease. We did not diagnose any associated neoplasm. The patient underwent four surgical resections for relapsed disease, varying from local excision to extended excision, including radical vulvectomy, with esthetic coverage. The margins were involved. Due to the extended target volumes, radiotherapy was rejected and the patient underwent a local topical therapy with Imiquimod 5%. The patient was free of disease, with three years of regular follow-ups. This case was challenging due to the long recurrence of the disease for approximately 26 years and due to the therapeutics issues that occurred.

Keywords: vulvar neoplasm; reconstructive surgical procedures; extramammary Paget’s disease; Imiquimod

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MDPI and ACS Style

Malek, B.; Ines, Z.; Yasmine, F.; Hatem, B.; Khaled, R. Chronic Vulvar Paget’s Disease: A Therapeutic Challenge with a Review of the Literature. J. Mind Med. Sci. 2019, 6, 356-360. https://doi.org/10.22543/7674.62.P356360

AMA Style

Malek B, Ines Z, Yasmine F, Hatem B, Khaled R. Chronic Vulvar Paget’s Disease: A Therapeutic Challenge with a Review of the Literature. Journal of Mind and Medical Sciences. 2019; 6(2):356-360. https://doi.org/10.22543/7674.62.P356360

Chicago/Turabian Style

Malek, Bouhani, Zemni Ines, Fertani Yasmine, Bouzaiene Hatem, and Rahal Khaled. 2019. "Chronic Vulvar Paget’s Disease: A Therapeutic Challenge with a Review of the Literature" Journal of Mind and Medical Sciences 6, no. 2: 356-360. https://doi.org/10.22543/7674.62.P356360

APA Style

Malek, B., Ines, Z., Yasmine, F., Hatem, B., & Khaled, R. (2019). Chronic Vulvar Paget’s Disease: A Therapeutic Challenge with a Review of the Literature. Journal of Mind and Medical Sciences, 6(2), 356-360. https://doi.org/10.22543/7674.62.P356360

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Chronic Vulvar Paget’s Disease: A Therapeutic Challenge with a Review of the Literature

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