Paget's disease of the vulva treated by wide excision and reconstruction with skin grafts and flaps: Reports of three cases.

Cho, Dong Hyu; Roh, Si Gyun; Lee, Jeong Heon

doi:2011.54.8.474

Obstet Gynecol Sci > Volume 54(8); 2011 > Article

Case Report

Korean Journal of Obstetrics & Gynecology 2011;54(8):474-479.
DOI: https://doi.org/10.5468/KJOG.2011.54.8.474 Published online August 1, 2011.

Paget's disease of the vulva treated by wide excision and reconstruction with skin grafts and flaps: Reports of three cases.

Dong Hyu Cho, Si Gyun Roh, Jeong Heon Lee

¹Department of Obstetrics and Gynecology, Chonbuk National University Medical School, Jeonju, Korea. jh.lee@jbnu.ac.kr
²Department of Plastic and Reconstructive Surgery, Chonbuk National University Medical School, Jeonju, Korea.

Abstract

Extramammary Paget's disease is a rare, slow-growing, non-invasive intraepithelial adenocarcinoma that occurs mainly in the elderly outside of the mammary gland. Paget's disease of the vulva accounts for less than 1% of all vulvar malignancies. The standard treatment is wide local excision of the gross lesion. To prevent a relapse, wide excision with adequate margins is necessary not to leave pathologic lesions around margins of excision. However, since the excised area is too wide to cover all the exposed surface with a simple closure only, skin grafts and flaps can be very useful. We report successful treatment of three cases of extramammary Paget's disease of the vulva using frozen section analyses of the margins during operation in order to attain Paget's cells free margins and skin grafts and flaps to cover an extensive defects.

Key Words: Paget's disease, Vulva, Skin grafts and flaps