īruce KH, Tran AM (2020) Treatment of invasive Paget’s disease of the vulva in pregnancy: a case report. īoret S, Lambert E, Charles VP, Philippe T, Ponette D, Darras J, Mattelaer P, Verbeke S, Lumen N, Decaestecker K (2021) Vulvar pagetoid urothelial intraepithelial neoplasia: a case report. Accessed January-March 2022.īae JM, Choi YY, Kim H, Oh BH, Roh MR, Nam K, Chung KY (2013) Mohs micrographic surgery for extramammary Paget disease: a pooled analysis of individual patient data. Oxford Centre for Evidence-Based Medicine. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.Ĭovidence systematic review software, Veritas Health Innovation, Melbourne, Australia. Sentinel lymph node biopsy is a useful tool to screen for subclinical nodal metastases in invasive disease, and can be used to help guide clinical management.ĭisease specific death Distant metastasis Extramammary paget disease Nodal metastasis Sentinel lymph node biopsy. In conclusion, invasive extramammary Paget disease is strongly associated with poor outcomes including nodal metastasis, distant metastasis, and disease specific death. After a mean follow up of 24 months, 9 subjects with a positive lymph node biopsy experienced nodal recurrence (11.7%), 15 had distant metastases (19.5%), and 13 died of the disease (16.9%). Of the positive cases, 11 (14.3%) had no further treatment, 54 (70.1%) underwent nodal dissection, 4 (5.2%) were treated with systemic agents, and 1 (1.3%) had radiation. Seventy-seven sentinel node biopsies (21.2%) were positive, including 12 in which the primary tumor had microinvasion (15.6%) and 56 with deep invasion (72.7%). Twenty-eight articles were included, with 366 subjects. Articles were included if they were in English and presented primary data on at least one patient with extramammary Paget disease who underwent sentinel lymph node biopsy in the absence of lymphadenopathy or known metastatic disease. Five databases were searched for relevant terms. This is performed intra-operatively by freezing sentinel lymph nodes to obtain multiple step-sections which are examined histologically for evidence of metastases. Multiple Step-section Frozen Section (MSFS) analysis is used in our institution for SLNB. We performed a comprehensive systematic review of the literature to further explore the role of sentinel lymph node biopsy in extramammary Paget disease. Sentinel Lymph Node Biopsy (SLNB) is the standard of care for axillary staging in breast cancer. Sentinel lymph node biopsy is increasingly used to detect subclinical nodal metastases in extramammary Paget disease.
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