utsumi toshiaki

An 82-year-old male visited a dermatologist for skin eruption in the left axilla 1 year and 3 months before visiting us. The lesion was treated externally as mycosis, but showed no improvement. As a result, the patient was referred to our department. A 5-cm erythematous lesion with partial erosion was present in the left axilla, and was diagnosed as extramammary Paget's disease by skin biopsy. The lesion was excised from the deep adipose tissue layer at 1-cm from the margin, followed by mesh skin grafting. There was no enlargement of the axillary lymph nodes. Left axillary lymph node swelling was noted 1 year and 2 months after surgery, and axillary lymph node metastasis was diagnosed by lymph node biopsy. Left axillary lymphadenectomy was subsequently performed. On whole body examination, no metastasis to any other organ was noted. As postoperative adjuvant therapy, irradiation at a total dose of 50Gy and 4 cycles of weekly administration of 40mg taxotere were given. No recurrence or metastasis of the tumor had occurred as of 10 months after lymphadenectomy, nor were there severe adverse effects of postoperative adjuvant therapy.[Skin Cancer (Japan) 2010 ; 25 : 33-37]