背景:乳腺外Paget病是一种相对罕见且恶性程度较低的上皮内腺癌。t存在于外生殖器等大汗腺分布丰富的地区,外生殖器,和肛周区域,更少的腋窝。该病进展缓慢,临床上容易误诊。
方法:我们回顾性分析了一名女性患者。她的左腋窝肿块超过2年。最近,质量增加,表面皮肤溃烂。然后她去了江西省皮肤科医院做左腋窝病变切除手术,术后病理显示乳腺外Paget病。为了进一步诊断和治疗,她来到我们医院。我们诊断出左腋窝乳腺动力学不确定或未知的肿瘤。在全身麻醉下,左腋下肿块切除术,进行冷冻和左乳腺癌保乳手术.
结果:左腋窝肿块术后病理结合形态学及免疫组化结果与Paget病一致。术后免疫组化显示雌激素受体(+,20%),孕激素受体(-),人表皮生长因子受体-2(3+),Ki-67(30%),细胞因子7(+),和p63(-)。跟进22个月,没有局部复发,右腋窝淋巴结没有肿胀,随访中未发现远处转移,没有上肢淋巴水肿等并发症,上肢感觉异常,或运动障碍已被观察到。
结论:腋窝外的Paget病相对罕见,手术切除是最好的选择。预后良好,复发率低。
BACKGROUND: Extramammary Paget disease is a relatively rare and less malignant intraepithelial adenocarcinoma. t is found in areas with abundant distribution of apocrine sweat glands such as the external genitalia, external genitalia, and perianal area, with fewer armpits. The disease progresses slowly and is prone to misdiagnosis in clinical practice.
METHODS: We retrospectively analyzed a female patient. She had a left axillary mass for more than 2 years. Recently, the mass increased and the surface skin was ulcerated. Then she went to Jiangxi Provincial Dermatology Hospital for left axillary lesion resection, and the postoperative pathology showed Paget disease outside the breast. For further diagnosis and treatment, she came to our hospital. We diagnosed a tumor with uncertain or unknown dynamics in the left axillary breast. Under general anesthesia, left subaxillary mass resection, freezing and left breast cancer breast conserving surgery was performed.
RESULTS: The postoperative pathology of the left axillary mass combined with morphological and immunohistochemical results was consistent with Paget disease. Postoperative immunohistochemistry showed estrogen receptor (+, 20%), progesterone receptor (-), human epidermal growth factor receptor-2 (3+), Ki-67 (30%), cytokine7 (+), and p63 (-). Following up for 22 months, there has been no local recurrence, no swelling of the right axillary lymph node, no distant metastasis found on follow-up, and no complications such as upper limb lymphedema, upper limb sensory abnormalities, or motor disorders have been observed.
CONCLUSIONS: Paget disease outside the axillary breast is relatively rare, and surgical resection is the best choice. The prognosis is good, and the recurrence rate is low.