Reconstruction with scrotal skin flaps after wide local resection of penoscrotal extramammary Paget's disease

Abstract

Study Type--Therapy (case series) Level of Evidence 4. What's known on the subject? and What does the study add? Both the treatment and reconstruction after resection of penoscrotal extramammary Paget's disease (EMPD) are of concern among oncological urologists. Reconstruction of large skin defects after wide local resection of this disease remains challenging and skilled work. For the first time, by using scrotal skin flaps, we have introduced an effective and reliable procedure into the new area of reconstruction for penoscrotal EMPD in selected patients, with satisfactory functional and aesthetic results.

Objective: • To introduce an effective procedure for reconstruction of large skin defects after wide local resection of penoscrotal extramammary Paget's disease (EMPD) in selected patients using scrotal skin flaps without compromising oncological control.

Patients and methods: • From January to June 2010 this procedure was carried out in five selected patients with penoscrotal EMPD who underwent wide local resection with subsequent reconstruction using scrotal skin flaps. • Patient demographics, lesion characteristics, surgical margins and outcomes were evaluated. • Skin defects covered 48-96 cm(2) (median = 72 cm(2)). The median (range) duration of follow-up was 24 (22-27) months.

Results: • Flaps survived with satisfactory functional and aesthetic results. • All patients survived without local or systemic recurrence of tumour.

Conclusions: • Wide local resection can provide cure in superficial penoscrotal EMPD. • The described method using scrotal skin flaps seems to be a safe and effective procedure for the reconstruction of large defects.