阴茎阴囊Paget病18例诊治分析

目的：探讨阴茎阴囊Paget病的临床特点和诊治方法，提高对阴茎阴囊Paget病的诊治水平。方法：对18例阴茎阴囊Paget病患者的临床资料进行回顾性分析，全部患者先行患处活检，后行术中快速冷冻切片辅助检查切缘的病灶根治性切除治疗，18例均未行预防性腹股沟浅组淋巴结清扫术。术后未行化疗或放疗。结果：术后18例患者均I期愈合。随访6个月～7年，平均32个月。2例复发，均为真皮层受累患者。其中1例局部复发，接受再次手术治疗，至今存活；1例术后2年发现腹股沟区淋巴结转移，再次手术1年后由于肺转移死亡。1例因其他疾病死亡。结论：阴茎阴囊Paget病应尽早行皮肤活检确诊，该病的首选治疗方法为术中快速冷冻切片辅助检查切缘的病灶根治性手术切除，手术效果好，预后满意，对复发者可行二次手术。

Clinical Analysis for 18 Cases of Paget's Disease Involving the Penis and Scrotum

Objective：To study the clinical features and treatment of Paget＇s disease of the penis and scrotum to improve treatment of Paget＇s disease of the penis and scrotum. Methods： Eighteen cases of Paget＇s disease of the penis and scrotum were studied retrospectively. All cases were biopsied around the lesion, then made frozen sec tion to check cutting edge in the operation. And all cases didn＇t accept preventive superficial group of inguinal lymph node dissection. Chemotherapy or radiotherapy were not applied during or after operation. Results： All cases were I stage healing and followed up for 6 month to 7 years（mean 32 months ）. 2 cases recurred, who were der mis involvement. 1 case with locally recurred is still alive after second operation. 1 case involved Inguinal lymph node metastasised after 2 years Postoperation, and died of Lung metastasis. And 1 died from other diseases. Conclusions：Paget＇s disease should be given diagnosis early with skin biopsy. Its preferred treatment is radical exci sion. And the Intraoperative rapid frozen section should be made to check the cutting edge. With these protocols operation effectiveness and prognosis will be good. Second opreation can be made on if recurrence occurred.