1. Interdisciplinary Management of Extramammary Paget's Disease Using Mohs Micrographic Surgery With Frozen Section Cytokeratin-7 Immunostains
- Author
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Julie M. Bittar, Peter G. Bittar, Shannon T. Nugent, Leela K. Raj, Donald E. Neal, Mohammed Dany, Marilyn T. Wan, John Sharkey, Jeremy R. Etzkorn, Joseph F. Sobanko, Thuzar M. Shin, Stephen Kovach, Robert C. Kovell, Nawar Latif, and Christopher J. Miller
- Subjects
Male ,Paget Disease, Extramammary ,Urology ,Keratin-7 ,Frozen Sections ,Humans ,Margins of Excision ,Neoplasm Recurrence, Local ,Mohs Surgery ,Retrospective Studies - Abstract
To describe local recurrence rates and patient-reported outcomes when Mohs micrographic surgery with cytokeratin-7 immunostains (MMS-CK7) is included in the interdisciplinary management of extramammary Paget's disease (EMPD) METHODS: A retrospective study was conducted of EMPD treated with MMS-CK7 as part of an interdisciplinary team at an academic medical center between 2009 and 2016. Local recurrence rates and patient-reported outcomes were determined by record review and patient surveys.Twenty tumors in 19 patients were treated using MMS-CK7. After MMS-CK7 defined clear microscopic margins, 75% (15/20) of tumors underwent excision or reconstruction by a surgical colleague. Internal malignancy screening was performed by multiple specialties in 17 patients, with 1 associated malignancy of prostate cancer detected. No local recurrence was detected with a mean follow-up of 75.2 months. Most patients were satisfied with appearance (18/19, 95%) and function (16/19, 84%) after surgery.Interdisciplinary teams that include MMS-CK7 can treat EMPD with low local recurrence rates, high patient satisfaction, and thorough internal malignancy screening.
- Published
- 2022