Spontaneous apparent clinical resolution with histologic persistence of a case of extramammary Paget's disease: Response to topical 5-fluorouracil

An 86-year-old woman presented with a 3-year history of an erythematous axi llary lesion, which was histologically confirmed to be extramammary Paget's disease (EMPD) confined to the epidermis and adnexa. Surprisingly, spontan eous clinical regression occurred in the lesion, but Paget's cells persiste d within the epidermis and adnexa on histologic examination. One year of in termittent topical chemotherapy with 5-fluorouracil resulted in ulcers that were interpreted as EMPD and completely excised. Histologic examination sh owed a complete absence of Paget's cells. To our knowledge, only one previo us report investigated apparent spontaneous clinical resolution with histol ogic persistence of EMPD. We emphasize that topical 5-fluorouracil cannot b e considered a safe treatment modality for EMPD, but it may be useful in ce rtain cases in which the extent of the lesions, or the general condition of the patient, advise against surgery or radiotherapy.