A Case of Secondary Extramammary Paget's Disease Surrounding a Cutaneous Ureterostoma After Recurrence of Bladder Urothelial Carcinoma

Abstract

ABSTRACT Introduction Secondary extramammary Paget's disease features intraepidermal carcinoma caused by tumor invasion and migration into adjacent skin. Case Presentation A 68‐year‐old man underwent radical cystectomy and bilateral cutaneous ureterostomy for bladder cancer and right ureteral cancer. Postoperative follow‐up computed tomography and urine cytology at 3 years suggested right ureteral cancer recurrence. Contemporaneous erythema and bulging of the skin around the right ureterocutaneous fistula were observed, necessitating retroperitoneoscopic nephroureterectomy and peristomal skin resection. Pathology revealed urothelial carcinoma with T2 disease at the lower ureter, plus spreading cytokeratin 7+ and cytokeratin 20+ pagetoid cells clustered within the epidermis indicative of secondary Paget's disease. Conclusion In cases of recurrent upper urothelial carcinoma after urinary diversion, patients may develop secondary extramammary Paget's disease of the skin.

Keywords

• bulging
• erythema
• Paget disease extramammary
• ureterocutaneostomy
• urothelial carcinoma