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High-dose-rate brachytherapy in scrotal extramammary Paget's disease: A case report

Published:December 09, 2022DOI:https://doi.org/10.1016/j.brachy.2022.08.009

      Abstract

      PURPOSE

      Extramammary Paget’s disease (EMPD) is a rare but lethal intraepithelial malignancy without standardized guidelines concerning diagnostic or therapeutic approaches. We report a case of EMPD of the scrotum treated with excellent results using high-dose brachytherapy.

      METHODS AND MATERIALS

      A 76-year-old male originally presented in 2015 with pruritus and erythema of the right scrotum, biopsy proved to represent extramammary Paget’s disease. He was treated for a year with topical creams without sustained relief. In July 2016 he underwent a right hemiscrotectomy which revealed stage 1 EMPD of the right scrotum and the medial thigh with positive margins but no deep invasion. Brachytherapy was selected as the most appropriate treatment option and carried out in December 2016 using HDR with a H.A.M. applicator and CT treatment planning.

      RESULTS

      On December 2021, at 5 years of clinical and pathological follow up, the patient remains NED with minimal skin toxicity.

      CONCLUSIONS

      High-Dose-Rate Brachytherapy appears to be a feasible treatment alternative as adjuvant therapy in patients with EMPD with incomplete resection.

      Keywords

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