Perianal Paget Disease Combined with Rectal Moderately Differentiated Adenocarcinoma Associated by Mucinous Adenocarcinoma: a Case Report

MO Li-ping; ZHANG Si-fen; CHEN Shi-wei

doi:10.3969/j.issn.1002-3429.2018.03.007

Abstract：Objective To investigate clinical characteristics of perianal Paget disease (PPD) combined with rectal moderately differentiated adenocarcinoma associated by mucinous adenocarcinoma.Methods Clinical data of a patient with PPD combined with rectal moderately differentiated adenocarcinoma associated by mucinous adenocarcinoma was retrospectively analyzed.Results The patient was referred to our hospital because of prolapse of anus neoplasm for 1 year.Physical examination performed at a local hospital identified extramammary Paget's disease.Physical examination showed intact vulva skin without rash,and cauliflower-like neoplasm around the anal with toughness,granular surface and a small amount of secretions.Upper edge of neoplasm at the right side of perianal area was 2 cm to the dentate line by digital rectal examination.After pelvic magnetic resonance imaging (MRI) examination and pathological examination of living tissues,we performed laparoscopic radical excision of rectum and anal tube associated with colostomy under tracheal cannula and general anesthesia.The patient was confirmed as having PPD combined with rectal moderately differentiated adenocarcinoma associated by mucinous adenocarcinoma according to intraoperative findings and pathological results.The patient was discharged after symptoms had been improved by postoperative chemotherapy.No recurrence was found during follow-up for 8 months.Conclusion PPD combined with rectal moderately differentiated adenocarcinoma associated by mucinous adenocarcinoma is rare in clinical settings,and timely histopathologic examination should be performed for early diagnosis.