Open Access

RESIDENT’S CORNER

Management of extramammary Paget’s disease with a staged, modified Mohs technique

Anant Shukla¹, Matthew Stringer², Pansy Uberoi², Steven Hudak², George Kallingal²

1 Department of Urology, Madigan Army Medical Center, Tacoma, Washington, USA
2 Department of Urology, San Antonio Military Medical Center, San Antonio, Texas, USA
Address correspondence to Dr. Anant Shukla, Department of Urology, Madigan Army Medical Center, 9040 Jackson Avenue Joint Base Lewis-McCord, Tacoma WA 98431 USA

Canadian Journal of Urology 2016, 23(4), 8382-8384.

Abstract

Extramammary Paget’s disease (EMPD) is a rare intraepithelial adenocarcinoma arising from apocrine glands. We describe an innovative surgical technique to manage extensive cutaneous malignancies in a notoriously challenging location. The patient is a 78-year-old male who presented with “jock itch” on his left groin refractory to topical treatment. A shave biopsy of the lesion demonstrated non-invasive EMPD which yielded a urology consult. Rather than the standard wide local excision (WLE), which can lead to positive margins, progression, and recurrence, we used a modified the Mohs technique and staged the procedure, providing excellent oncologic and cosmetic outcomes. The described technique has particular merit with uncertain margin status and when geography of lesions preclude a standard Mohs surgery.

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Keywords

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