Objective: To probe the relationship of clinicopathologic presentations and prognosis of Paget's disease primarily involving the scrotum.
Methods: 11 cases of scrotal Paget's disease were studied retrospectively from 1984 to 1997. PAS was stained and EMA, S-100, HMB45, CEA and CA15-3 were immunostained in all cases for the differential diagnosis from Bowen's disease and malignant melanoma.
Results: Six of 11 cases involved hair follicle and/or sweat glands, and 3 cases involved dermis (one had metastasis of left superficial and deep inguinal lymph nodes, and left internal iliac lymph nodes). Paget's cells were positive for PAS (11/11), EMA (11/11), CEA (6/11), CA15-3 (11/11), and negative for S-100, HMB45. Wide local excision of the lesions was performed in 10 of 11 patients both for primary disease and recurrent disease. 3 of the 10 patients underwent lymph nodes resection and metastasis was found in 1 case pathologically. One patient accepted chemotherapy and died, from respiratory insufficiency after one month. The other 10 patients were followed up for 6 to 127 months and no patient died of Paget's disease.
Conclusions: Involvement of hair follicles and sweat glands by Paget's cell does not influence the prognosis.However, invasion of dermis by Paget's cells may suggest possible metastasis.