An effective case of M-VAC therapy of advanced bladder cancer with extramammary Paget's disease

A 66-year-old man complained of gross hematuria, lower abdominal mass and perineal skin erosion. Intravenous pyelography showed a filling defect in the right bladder wall. CT scan demonstrated multiple liver metastasis and lower abdominal mass. Skin biopsy of perineal lesion revealed extramammary Paget's disease. The histopathological study of bladder tumor and lower abdominal mass revealed both to be transitional cell carcinoma grade 3. After four courses of M-VAC therapy described by Sternberg in 1985, bladder tumor and metastatic lower abdominal mass disappeared with CT scan and this effect continued over 6 months. Skin biopsy after chemotherapy revealed a marked reduction in Paget's cell number.