Modified peripheral and central Mohs micrographic surgery for improved margin control in extramammary Paget disease
Michael S. Chang, Patrick M. Mulvaney, Melissa Danesh, Colleen M. Feltmate, Chrysalyne D. Schmults
Abstract
Extramammary Paget disease (EMPD) is a rare intraepithelial adenocarcinoma of pluripotent keratinocyte stem cells, which typically occurs in elderly patients.1 The current standard of care involves surgical treatment with either wide local excision (WLE) or Mohs micrographic surgery (MMS). For vulvar cases, radical resection, such as complete vulvectomy, may be performed. However, along with significant procedural morbidity, tissue margins are often positive following resection, occurring in as frequently as 97% of cases in some series.
Topics & Concepts
MedicineExtramammary Paget's diseaseMohs surgeryWide local excisionPaget DiseaseDermatologySurgeryVulvar intraepithelial neoplasiaAdenocarcinomaResection marginVulvaVulvar neoplasmResectionDiseasePathologyCancerInternal medicineCancer and Skin LesionsNonmelanoma Skin Cancer StudiesHedgehog Signaling Pathway Studies