Extramammary Paget disease of the perianal region: the potential role of imiquimod in achieving disease control

Stephen R. Knight, Charlotte Proby, Dorin Ziyaie, Frank Carey, Sacha Koch (Lead / Corresponding author)

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Abstract

Extramammary Paget disease (EMPD) is a rare perineal neoplasia associated with a high rate of local recurrence. Surgical excision is the standard treatment; however, this has high rates of post-operative morbidity in combination with potentially mutilating results. Previous literature has demonstrated good response with imiquimod 5% cream in patients with vulval EMPD, yet its effectiveness in primary perianal disease is unknown.We describe the case of a 40-year-old woman presenting with EMPD of the perianal region, providing detailed histological and pictoral evidence of its response to topical imiquimod 5% cream over a 16-week period, which initially resulted in remission prior to metastatic lymph node recurrence. This case demonstrates the potential for topical imiquimod cream to avoid major surgery and its associated complications in patients presenting with EMPD of the perianal region. We discuss the current evidence for treating this rare condition with medical therapy, how this case adds to current literature and possible future directions.

Original languageEnglish
Pages (from-to)1-3
Number of pages3
JournalJournal of Surgical Case Reports
Volume2016
Issue number8
Early online date9 Aug 2016
DOIs
Publication statusPublished - Aug 2016

Keywords

  • Journal article

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