Surgical Treatment of Brain Metastasis of Extramammary Paget’s Disease: A Case Report

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  • Miura Shimpei
    Department of Neurosurgery, Osaka National Hospital, National Hospital Organization, Osaka, Osaka, Japan Department of Neurosurgery, Osaka University, Graduate School of Medicine, Suita, Osaka, Japan
  • Kijima Noriyuki
    Department of Neurosurgery, Osaka National Hospital, National Hospital Organization, Osaka, Osaka, Japan Department of Neurosurgery, Osaka University, Graduate School of Medicine, Suita, Osaka, Japan
  • Fujimori Nagisa
    Department of Dermatology, Osaka National Hospital, National Hospital Organization, Osaka, Osaka, Japan
  • Nakagawa Tomoyoshi
    Department of Neurosurgery, Osaka National Hospital, National Hospital Organization, Osaka, Osaka, Japan
  • Nakagawa Ryota
    Department of Neurosurgery, Osaka National Hospital, National Hospital Organization, Osaka, Osaka, Japan
  • Tachi Tetsuro
    Department of Neurosurgery, Osaka National Hospital, National Hospital Organization, Osaka, Osaka, Japan
  • Okita Yoshiko
    Department of Neurosurgery, Osaka National Hospital, National Hospital Organization, Osaka, Osaka, Japan
  • Kanemura Yonehiro
    Department of Neurosurgery, Osaka National Hospital, National Hospital Organization, Osaka, Osaka, Japan
  • Nakajima Shin
    Department of Neurosurgery, Osaka National Hospital, National Hospital Organization, Osaka, Osaka, Japan
  • Mano Masayuki
    Department of Central Laboratory and Surgical Pathology, Osaka National Hospital, National Hospital Organization, Osaka, Osaka, Japan
  • Kishima Haruhiko
    Department of Neurosurgery, Osaka University, Graduate School of Medicine, Suita, Osaka, Japan
  • Ozawa Kentaro
    Department of Dermatology, Osaka National Hospital, National Hospital Organization, Osaka, Osaka, Japan
  • Fujinaka Toshiyuki
    Department of Neurosurgery, Osaka National Hospital, National Hospital Organization, Osaka, Osaka, Japan

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Abstract

<p>Extramammary Paget’s disease (EMPD) is a rare form of neoplasm. Metastasis of EMPD to locations other than lymph nodes and intra-epithelial regions is rare; there are a limited number of case reports of metastases to the liver, lung, bone, and brain. We present a rare case of EMPD that metastasized to the brain and was treated with surgical resection. A 66-year-old man presented with a small palpable mass in the scrotum. After 5 years of observation, he was diagnosed with EMPD that metastasized to the lymph nodes and lung. Tumor resection and postoperative chemotherapy were performed. Six months after the last chemotherapy treatment, he presented with a right temporal lobe tumor and underwent surgical resection. Histopathological analysis revealed brain metastasis of EMPD. Three months after surgery, magnetic resonance imaging (MRI) showed local tumor recurrence, and intensity modulated radiation therapy (IMRT) (45 Gy/15 Fr) was performed. Although the metastatic brain tumor was well controlled, the primary tumor progressed. He was provided best supportive care and died 5 months after brain tumor resection. In this report, we present a rare case of brain metastasis of EMPD, treated with surgical resection, and histopathologically confirmed to be metastatic EMPD.</p>

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