Genital Paget's Disease

Abstract

Paget's disease, mammary and extramammary, has been the subject of controversy for more than 4 score years. The meticulous study of Bennett1has demonstrated that Paget's disease of the nipple is always associated with an adenocarcinoma in the underlying breast. No such comprehensive investigation has been done on extramammary Paget's disease. This condition is most commonly seen in the genital, perianal, and axillary regions. Two entities have been described. Some patients have a primary carcinoma of an underlying organ (anal canal, prostate)2with lymphatic extension of the tumor to the epidermis. In the other type, which this paper will discuss, there is no underlying carcinoma. At present there are 2 hypotheses regarding pathogenesis. Woodruff3and Woodruff and Richardson4feel that vulvar Paget's disease is a carcinoma of epithelial origin, whereas Weiner5and more recently, Dockerty and Pratt,6support the thesis that Paget's cells migrate