Variable patterns of positron emission tomography in the assessment of patients with extramammary Paget's disease

Abstract

Whole body 18F-fluorodeoxyglucose (FDG) positron emission tomography was performed for staging in 7 extramammary Paget's disease patients and 4 tests showed mild FDG uptake at the primary sites. Histologically, all 4 tumors were found to be thicker than 2 cm. Among the 4 patients, 2 showed multiple hypermetabolic foci of skeletal metastasis and lymph node involvement.

Extramammary Paget's disease (EMPD) is a heterogenous condition representing either an intraepithelial adenocarcinoma in situ with potential to become invasive, or pagetoid spread of an underlying adnexal tumor or a regional internal malignancy.1 A thorough general physical examination, along with laboratory and radiographic testing, with emphasis on the region adjacent to the site of EMPD is indicated when genitalia or perianal skin are involved, as they may be associated with underlying neoplasms of the genitourinary or gastrointestinal tracts.

Between May 2000 and July 2004, whole body 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) was performed for staging in 7 EMPD patients. All 7 were male and mean age was 63.9 years with age ranging from 55 to 75 years. Location, size, and thickness of the tumor are summarized in Table I. Other imaging studies, including gastrointestinal endoscopy, intravenous pyelogram, and abdominopelvic ultrasonography were performed and did not show remarkable findings in any of the 7 patients.