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Dr. Andrew Rynne

Family Physician

Exp 50 years

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How to treat paget disease of vulva?

im a 62 years old woman, I just got a report from my doctor today that i got Paget disease of vulva , The specimen container is labelled with the patient s ID but not the specimen type n consists of a yellowish tan skin punch biopsy measuring 0.2x0.2x0.9cm. The punch biopsy includes skin n subcutaneous tissue. Sections of the skin show within the epidermis there are scattered large pale vacuuolate tumour cells occurring mainly singly with a few small clusters noted. The tumour cells have atypical nuclei with occasional prominent nucleoli noted. Mucin stain (PAS+D) shows strong cytoplasmic positively in the tumour cells. Within the dermis there is a dilated benign duct present. No underlying invasive carcinoma is seen in the biopsy. Immunohistochemical staining of the tumour cells in the epidermis show strong positive for CK7. The tumour cells are negative for CK20,S-100 and HMB45. The histological and immunohistochemical features are those of Paget disease of vulva. Actually i felt the problem a few years again in 2011, but the family check n check but can t find the reason, until now I got this report. So i need more advices from different doctors, is that disease a life threatening disease? what can I do now? I worry ! thanks for doctors advice....
Wed, 8 May 2019
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OB and GYN Specialist 's  Response
Hello,

Treatment included surgery, radiation therapy, photodynamic therapy, CO2 laser therapy and, in one case, imiquimod cream application. All four cases of female genital Paget's disease recurred or persisted. Imiquimod cream appears to be a promising option for clinical treatment of vulvar Paget's disease.

Hope I have answered your query. Let me know if I can assist you further.

Regards,
Dr. Naira Jahangir, OB and GYN Specialist
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