Case Report: A Long-standing Misdiagnosed Case of Penile Extramammary Paget’s Disease
Yelona Shrestha1*, Nutana Shrestha2, Ghizlane Mardy3, Ram Prasad Chaulagain4
1Department of Dermatology, Henan Medical University, Henan, China.
2College of Environment and Civil Engineering, Chengdu University of Technology, Chengdu 610059, China.
3College of Computer Science and Network Security, Chengdu University of Technology, Chengdu 610059, China.
4Department of Gastroenterology and Hepatology, Harbin Medical University, Harbin, China.
*Corresponding Author: Yelona Shrestha, Department of Dermatology, Henan Medical University, Henan, China.
DOI: https://doi.org/10.58624/SVOAMR.2026.04.016
Received: July 17, 2026
Published: August 11, 2026
Citation: Shrestha Y, Shrestha N, Mardy G, Chaulagain RP. Case Report: A Long-standing Misdiagnosed Case of Penile Extramammary Paget’s Disease. SVOA Medical Research 2026, 4:4, 144-147. doi: 10.58624/SVOAMR.2026.04.016
Abstract
Extramammary Paget's disease (EMPD) is a rare intraepithelial adenocarcinoma that commonly arises in apocrine gland-rich regions, particularly the genital and perianal areas. Its nonspecific clinical manifestations often mimic benign inflammatory dermatoses, leading to delayed diagnosis and management. We describe a case of invasive penile EMPD in a 79-year-old man with a 10-year history of persistent scrotal erythema and swelling. The lesion was initially managed as dermatitis with topical corticosteroids, resulting in only temporary symptomatic improvement. Progressive enlargement and extension to the penis and perineum prompted further evaluation. Histopathological examination revealed characteristic large, atypical Paget cells infiltrating the epidermis and dermis in nests and cords within a fibro collagenous stroma, confirming the diagnosis of invasive EMPD. The patient subsequently underwent chemotherapy with cyclophosphamide and paclitaxel. This case underscores the diagnostic difficulty of EMPD and highlights the importance of maintaining a high index of suspicion and performing early biopsy in chronic, non-resolving genital lesions. Early histopathological diagnosis is crucial for timely intervention and for reducing the risk of local invasion and metastatic spread.
Keywords: Extramammary Paget's disease; Penile Paget's disease; Delayed diagnosis; Histopathology; Chronic eczema; Cutaneous adenocarcinoma.