Recurrent bladder cancer associated with vulvar pagetoid lesion.

概要

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A 77-year-old female patient, who was diagnosed with bladder cancer and was operated on for it 7 years before, had noticed erythema with itching on her vulvar lesion 4 months berore. She had visited a near clinic and was reffered to our hospital. Physical examination revealed an erythematous plaque with an regular margin from the bilateral labia majus to labia minus. There were two erosions, which was on the right side of the labium minus (diameter 2.5×2.5cm) and was the left side of the labium minus (diameter 1.0×1.0cm). A skin biopsy from the erythema plaque showed large round cells with ample cytoplasm, which formed nests or glandular structures within the irregularly acanthotic epidermis. The tumor cells in the epidermis were histochemically positive for CK7 and CK20, but negative for CEA, PAS and GCDFP15.MRI examination found the mass formation of the reccurence bladder cancer near the vagina. A skin biopsy from the vagina was the same histological and histochemical findings of the epidermis and was connected with the above mass formation.Therefore, this case was suspected of the intraepidermal invasion, so called pagetoid spread, followed by reccurence bladder cancer. [Skin Cancer (Japan) 2000; 15 : 284-288]