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Metastatic Extramammary Paget Disease of the Perianal Region

Mandava, Anitha, MBBS, DMRD, DNB (Radiodiagnosis)*; Koppula, Veeraiah, MBBS, DNB (Radiodiagnosis)*; Yalamanchili, Rohit, MD (Radiodiagnosis)*; Ali, Zakir, MBBS, DNB (Nuclear Medicine)

doi: 10.1097/RLU.0000000000002619
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A 72-year-old man with history of itching for 8 months presented with an ill-defined, ulcerated, eczematous, thickened cutaneous lesion in the left perianal region. 18F-FDG PET/CT was performed, and neoplastic skin thickening with FDG uptake was seen at the left gluteal cleft. Hypermetabolic inguinal, retroperitoneal, and mediastinal lymph nodes, liver, and bone metastases were seen. Histopathology and immunohistochemistry of the perianal growth and left inguinal lymph node were positive for cytokeratin7 and gross cystic disease fluid protein and negative for cytokeratin 20 and CDX2, confirming the diagnosis of primary extramammary Paget disease with metastases.

From the Departments of *Radiodiagnosis, and

Nuclear Medicine, Basavatarakam Indo American Cancer Hospital & Research Institute, Hyderabad, Telangana, India.

Received for publication November 20, 2018; revision accepted April 1, 2019.

Conflicts of interest and sources of funding: none declared.

Author Contributions: A.M. and V.K. researched literature and conceived the study. A.M., V.K., R.Y., and Z.A. were involved in image aquisition and data analysis. A.M. wrote the first draft of the manuscript. All the authors reviewed and edited the manuscript and approved the final version of the manuscript.

Correspondence to: Anitha Mandava, MBBS, DMRD, DNB (Radiodiagnosis), 1-7-139/75, S. R. K. Nagar, Risalagadda, Musheerabad, Hyderabad, Telangana, India 500020. E-mail:

Online date: May 17, 2019

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