Recurrent Paget's disease of the vulva in a myocutaneous flap: Case report and review of the literature

A 74-year-old patient with recurrent Paget's disease of the vulva in the gluteus maximus island myocutaneous flap 11 years after a hemivulvectomy with reconstruction is presented. This report is only the second case of recurrent noninvasive Paget's disease in a reconstructive flap. The English literature on this subject is reviewed with special attention to the biological behavior of these tumors.

Paget; Vulva; Recurrence; Myocutaneous flap

[1] Curtin J.P.,R ubin S. C.,J ones W. B.,H oskins W. J.,L ewis J. L: "Paget's disease of the vulva". Gynecol. Oncol., 1990, 39, 374.

[2] Fanning J.,L ambert H. C.,H ale T. M.,M orris P. C.,S chuerch C.: "Paget's disease of the vulva: prevalence of associated vulvar adcnocarcinoma, invasive Paget's disease, and recurrence after surgical excision". Am. J. Ohstet. Gynecol., 1999, 180, 24.

[3] Scheistroen M.,T rope C., Kaern J.,P ettersen E. 0.,A lfsen G. C., Nesland J.M.: "DNA ploidy and expression of p53 and c-erbB-2 in extramammary Paget's disease of the vulva". Gynecol. Oncol., 1997, 64, 88.

[4] Creasman W.T .,G allager H. S.,R utledge F.: "Paget's disease of the vulva". Gynecol. Oncol., 1975, 3, 133.

[5] Feuer G. A., Schevchuk M., Calanog A.: "Vulvar Paget's disease the need to exclude an invasive lesion". Gynecol. Oneal., 1990, 38, 81.

[6] Stacy D., Burell M. O., Franklin E. W.: "Extramammary Paget's disease of the vulva and anus: use of intraoperative frozen-section margins'·. Am. J. Ohstet. Gvnecol., 1986, 155, 519.

[7] Fishman D. A.. Chambers S. K., Schwartz P. E.. Kohorn E. I.. Chambers J. T.: "Extramammary Paget's disease of the vulva" Gvnecol. Oncol.. 1995, 56, 266.

[8] DiSaia P. J., Dorion G. E., Cappuccini F., Carpenter P. M.: "A report of two cases of recurent Paget's disease of the vulva in a split-thickness graft and its possible pathogenesis-labeled " retrodisemination". Gynecol. Oncol., 1995, 57, 109.

[9] Garzetti G. G., Bertani A.,T ranquilli A.L .,T iriduzzi M., Valensise H., Romanini C.: "Paget's disease of the vulva: advantage of demolitive surgery". Eur. J. Gynaecol. Oneal.,1992, 13, 74.

[10] Misas J. E.,L arson J. E.,P odczaki E.,M anetta A.. Mortel R.: "Recurrent Paget disease of the vulva in a split-thickness graft". Obstet. Gynecol., 1990, 76, 543.

[11] Beecham C. T.: "Paget's disease of the vulva. Recurrence in skm grafts". Obstet. Gynecol., 1976, 47, 55s.

[12] de Jonge E.T., Knobel J.: "Recurrent Paget's disease of the vulva after simple vulvectomy and skin grafting. A case report". S. Afr. Med. J., 1988, 73, 46.

[13] Geisler J.P.,S towell M. J.. Melton M.E .,M aloney C.D .,Geisler H. E.: "Extramammary Paget's disease of the vulva recurring in a skin graft". Gynecol. Oncol., 1995, 56, 446.

[14] Yoshitatsu S., Hosokawa K., Nishimoto S., Yoshikawa K.: "A case of Paget's disease of the vulva recurring in a musculocutaneous flap".J. Dermatol., 1997, 24, 471.

[15] Singer A., Monaghan J.M.: "Lower genital tract precancer, Paget's disease". In: Lower Genital Tract Precancer, Singer A., Monaghan J.M. (eds.),L ondon,B lackwell ScientificP ublications, 1994, 202.