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A Case of Rectal Carcinoma Accompanied by Extensive Extramammary Paget's Disease: Special considerations on the histological interrelationship S. Izumoi 1 , T. Murakami 1 , N. Aoki 2 11st Dept. of Surgery, Tokyo Medical and Dental Univ., School of Medicine 2Dept. of Pathology, Tokyo Medical and Dental Univ., School of Medicine pp.233-239
Published Date 1978/2/25
DOI https://doi.org/10.11477/mf.1403107219
  • Abstract
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 We have experienced a case of rectal carcinoma accompanied by extensive extramammary Paget's disease in the perianal region and the histopathological interrelationship was considered.

 The presented case is a 77-year-old female who suffered from the perianal skin lesion for two years. This turned out to be extramammary Paget's disease by the skin biopsy. During the evaluation of the rectal bleeding, the rectal tumor was found to be a mucinous carcinoma of the rectum by the biopsy. On October 28, 1975, abdomino-perineal rectal amputation was performed. The entire resected specimen was examined for the histological evaluation. The type of carcinoma was a well differentiated papillotubular, mostly mucinous adenocarcinoma, invading the adventitia and classified in the Dukes C. Lymph node metastasis was counted out 13/25. The tissue in the skin lesion contained scattered Paget's cells in the epidermis which were positive by Diastase ersistant PAS, Aldehydefuchsin, Mucicarmine and Alcian Blue stainings. The rectal carcinoma was also stained positive by them. The PAM starining demonstrated the invasion of the metastatic rectal carcinoma from the subcutaneous tissue to dermal layer. No Paget's cells were identified in the appendages of the skin.

 The histological examination of the rectal carcinoma and the extramammary Paget's disease demonstrated the following findings:

 1) The histological continuance between the rectal carcinoma and the extramammary Paget's disease existed in the dermal layer.

 2) Paget's cells were found in the dermal layer where the malignant cells of the rectal carcinoma infiltrated up beyond the basal membrane of the epidermis.

 According to the above, the pathogenesis of the extramammary Paget's disease was strongly suggestive of the infiltration of the rectal carcinoma into the epidermal layer, although the ultrastructural and histochemical studies are neccessary to solve the interrelationship between rectal carcinoma and extramammary Paget's disease.


Copyright © 1978, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院

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