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Synchronous Primary Perianal Paget's Disease and Rectal Adenocarcinoma: Report of a Hitherto Undescribed Phenomenon

^* To whom correspondence should be addressed. E-mail: pargani{at}jhmi.edu.

	Abstract

Perianal Paget’s disease is rare. It usually represents intraepidermal extension of an invasive carcinoma from an adjacent internal organ, but some cases represent primary intraepithelial cutaneous apocrine adenocarcinomas. Here, we report a unique case, which we interpret as synchronous primary perianal Paget’s disease and lower rectal adenocarcinoma. Immunohistochemical stains demonstrated that the Paget’s cells were CK7⁺/CK20^-/GCDFP⁺, whereas the rectal adenocarcinoma was CK7⁺(variable)/CK20⁺/GCDFP^-. This discordant immunoprofile supported our impression that the Paget’s disease in this patient was of cutaneous apocrine origin rather than a pagetoid extension from the patient’s nearby rectal adenocarcinoma—to our knowledge a hitherto undocumented occurrence.

First published on May 21, 2008, doi:10.1177/1066896908316069

International Journal of Surgical Pathology 2009;17:42.

A more recent version of this article appeared on February 1, 2009


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