Paget's Disease of the Vulva Treated with Imiquimod: Case Report and Systematic Review of the Literature
| Autor: | Lukas Hefler, Askin Dogan, Harald Krentel, Clemens B. Tempfer, Ziad Hilal, Cem Cetin, Christoph Grimm |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
medicine.medical_specialty
Administration Topical medicine.medical_treatment Genital neoplasia Skin Cream Antineoplastic Agents Imiquimod Extramammary Paget's disease Vulva 030207 dermatology & venereal diseases 03 medical and health sciences 0302 clinical medicine Adjuvants Immunologic Humans Medicine Local Reaction Vulvar Neoplasms business.industry Obstetrics and Gynecology Histology medicine.disease Dermatology Paget s disease Paget Disease Extramammary medicine.anatomical_structure Reproductive Medicine 030220 oncology & carcinogenesis Aminoquinolines Female business Adjuvant medicine.drug |
| Zdroj: | Gynecologic and Obstetric Investigation. 82:1-7 |
| ISSN: | 1423-002X 0378-7346 |
| DOI: | 10.1159/000449158 |
| Popis: | Background: Extramammary Paget's disease of the vulva (EPDV) is a rare adenocarcinoma in situ of the vulvar skin and is often resected with involved margins due to its reticular growth pattern. Adjuvant treatment with the immunomodulator imiquimod may be suitable to avoid repeated and mutilating surgery. Case Presentation: We present the case of a 73-year-old woman with EPDV, initially treated with surgical resection and re-resection for involved margins. Final histology revealed Paget's disease of the left vulva with 8 cm in the largest diameter and again involved margins. Subsequently, topical therapy with imiquimod 5% cream twice weekly was applied for 3 months. Vulvoscopy and local biopsies confirmed complete remission (CR). Based on a literature search using PubMed and the Cochrane Central Register of Controlled Trials, 21 reports on the therapeutic efficacy of imiquimod in 70 women with EPDV have been published. Pooled rates of CR and partial remission were 71% (50/70) and 16% (11/70), respectively. There were 4 cases of disease progression under imiquimod and the therapy was generally well tolerated with mild to moderate local reactions in >50% of cases. Conclusion: EPDV is a rare genital neoplasia and may be successfully treated with the topical immunomodulator imiquimod. Specifically, adjuvant imiquimod is a feasible and efficacious treatment option for women with involved resection margins after surgery. |
| Databáze: | OpenAIRE |
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