Transitional cell carcinoma of the bladder mimicking recurrent Paget's disease of the vulva: Report of two gases, with one occurring in a myocutaneous flap

Background. Transitional cell carcinoma of the bladder may spread superfici ally along and beyond the urogenital epithelium, mimicking vulvar Paget's d isease. Cases. These two cases illustrate unusual aspects of transitional cell carc inoma of the bladder and vulvar Paget's disease. Both patients had a histor y of breast cancer and previously had multiple operations for recurrent vul var Paget's disease; one patient had a radical vulvectomy with transverse r ectus abdominal muscle flap reconstruction. Both had a history of recurrent transitional cell carcinoma of the bladder. Both presented with recalcitra nt transitional cell carcinoma of the bladder and clinically recurrent vulv ar Paget's disease. Pathologic evaluation, however, revealed pagetoid sprea d of carcinoma in situ (CIS) throughout the urothelium, with an invasive co mponent in the cervix and extension of the CIS into the rectum in one patie nt. Conclusion. If the history of the patient includes transitional cell carcin oma of the bladder and vulvar Paget's disease, histologic evaluation is nee ded for accurate diagnosis and proper treatment. (C) 2001 Academic Press.