[Clinicopathologic and immunohistochemical features of vulvar Paget diseases]

Abstract

Objective: To improve understanding the factors of development, recurrence and prognosis of vulvar Paget disease (VP).

Methods: Clinicopathologic analyses were performed in 14 patients with VP treated in our hospital from Jan 1959 to Dec 1996. Immunohistochemical stainings for CK7, 34 beta E12, carcinoembryonic antigen (CEA), C-erbB2 and HMB45 were carried out in 6 cases.

Results: The mean duration from manifestation of symptoms to diagnosis was 57.1 months. The local recurrent rate after operation was 69%. The mean period from the initial operation to recurrence was 68.8 months. 2 cases out of 4 intraepithelial VP cases recurred with positive surgical margins, but no recurrence in of the other 4 cases with negative surgical margins. Immunohistochemical stainings for CK7 and CEA in 6 cases with VP showed strong positive, whereas for 34 beta E12 and HMB45 in all 6 cases were negative, and for C-erbB2 in 2 cases were positive.

Conclusions: The findings that CK7 and CEA positive in Paget cell of VP, whereas 34 beta E12 and HMB45 negative, suggests that Paget cell of VP possesses characteristics of adenocarcinoma. The recurrence of VP correlates with positive surgical margins. Long term follow-up after operation is essential for VP. The prognosis of intraepithelial and minimally invasive VP was favourable, adjunctive radiotherapy after operation was effective for invasive VP in our studied cases.