Case of Paget disease except breast showing high serum CA19-9 value.

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A case of extramammary Paget's disease with pedunculated tumor formation is reported. A 65-year-old woman had noticed a pruritic eruption on her left vulva 4 or 5 years ago. At her first visit, a pedunculated tumor about 3cm in diameter was found within an erythematous plaque intermingled with depigmented spots on her left vulva. Inguinal lymph nodes on both sides were palpable. Serum levels of CA19-9 as well as CEA were elevated. Histopathological examination revealed that the epidermis was permeated with Paget cells in groups, and the dermis was also infiltrated with a mass of Paget cells. Immunohistochemically, CEA and CA19-9 were expressed on tumor cells.After radical excision, serum levels of CEA and CA19-9 decreased rapidly. But 5 months after the operation, the tumor apparently recurred or metastasized because serum levels of CEA and CA19-9 became elevated again.
日本皮膚悪性腫瘍学会の論文