Table of Contents
Definition / general | Case reports | Treatment | Clinical images | Gross description | Microscopic (histologic) description | Microscopic (histologic) images | Positive stains | Electron microscopy description | Differential diagnosisCite this page: Hale CS. Extramammary Paget disease. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/skintumornonmelanocyticpagets.html. Accessed September 22nd, 2023.
Definition / general
- May originate from intraepidermal portion of sweat glands or primitive basal cells with ability to differentiation towards glandular elements
- Labia majora, scrotum and perineum are most common sites
- Due to underlying carcinoma in 10 - 20% of cases of vulvar disease
Case reports
- 66 year old woman with vulvar Paget disease (BMC Cancer 2010;10:405)
Treatment
- Complete surgical excision
Gross description
- Erythematous, eczematous or ring shaped
- Often multicentric, extensive, pigmented
Microscopic (histologic) description
- Malignant cells in epidermis with differentiation towards local glandular structures
- Almost always simultaneous involvement of eccrine glands or hair follicles
- Dermal invasion is rare in vulva, more common in perianal region)
- Single, clusters or glandular formations of large cells with pale, vacuolated cytoplasm, usually just above basal layer of epidermis
- May have cleft-like spaces between Paget cells and neighboring keratinocytes
- No intercellular bridges, no dyskeratosis
Microscopic (histologic) images
Positive stains
Electron microscopy description
- Cells with glandular differentiation, not melanocytes or keratinocytes
Differential diagnosis
- Clear cell papulosis
- Metastatic epidermotropic carcinomas
- Melanocytic lesions
- Pagetoid actinic keratosis
- Pagetoid Bowen disease