Arch Hand Microsurg.  2018 Mar;23(1):59-62. 10.12790/ahm.2018.23.1.59.

Perianal Paget's Disease Reconstruction with Bilateral Pacman Flap

• Jang SY
• Bae TH
• Kim WS
• Kim HK

• KMID: 2412492
• DOI: http://doi.org/10.12790/ahm.2018.23.1.59

Abstract

Extramammary Paget's disease is uncommon slow-growing intraepithelial adenocarcinoma which usually occurs in area of body where apocrine glands are present. A 70-year-old man had a dermatologic evaluation for anal bleeding and underwent a skin biopsy with diagnostic of Paget's disease in perianal region. Wide excision under intraoperative frozen biopsy and reconstruction operation was performed under general anesthesia. Final defect shape was elliptical and bilateral Pacman flap was performed. Elliptical perianal defect was successfully reconstructed without any complications such as congestion, partial necrosis or infection.

Keyword

Perianal Paget's disease; Extramammary Paget's disease; Pacman flap

MeSH Terms

Adenocarcinoma in Situ
Aged
Anesthesia, General
Apocrine Glands
Biopsy
Estrogens, Conjugated (USP)
Hemorrhage
Humans
Necrosis
Paget Disease, Extramammary
Skin
Estrogens, Conjugated (USP)

Figure

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  Fig.1. Removed skin lesion.

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  Fig.2. Final defect after wide excision based on intraoperative frozen biopsy.

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  Fig.3. Immediate postoperative image.

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  Fig.4. Four months postoperative image.

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