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目的探讨阴囊阴茎Paget’s病的临床特点和诊治方法。方法对13例阴囊阴茎Paget’s病患者的临床、病理资料以及治疗随访情况进行回顾性分析。结果所有13例均经手术治疗,施行局部扩大的病灶切除术;10例用剩余的阴囊皮肤覆盖创面,3例行游离植皮术。其中1例在病程中复发3次,均经手术切除,现随访6个月无复发;其它12例经一次手术后随访2~64月无复发。3例腹股沟淋巴结肿大者有1例系癌转移。所有病例未发现远处转移。结论本病的诊断主要依靠病理;局部扩大的病灶切除术是治愈的关键,对于皮肤缺损可用阴囊皮瓣及游离植皮的方法覆盖;腹股沟淋巴结肿大不一定是癌转移;切除范围不够、瘤细胞侵入真皮层、病灶中有腺癌成分是复发的主要原因。
Objective To investigate the clinical features, diagnosis and treatment of Paget’s disease in scrotum penis. Methods The clinical and pathological data of 13 cases with Paget’s disease of penis penis and the follow-up of treatment were analyzed retrospectively. Results All 13 cases were surgically treated with locally enlarged focal resection. The wounds were covered with the remaining scrotal skin in 10 cases and the free skin graft in 3 cases. One case of recurrence in the course of 3 times, were surgically removed, no recurrence 6 months follow-up; the other 12 cases were followed up after a surgery from 2 to 64 months without recurrence. One case had carcinoma metastasis in 3 cases with enlarged inguinal lymph nodes. No distant metastases were found in all cases. Conclusions The diagnosis of this disease mainly depends on the pathology. The focal enlargement of focal lesion is the key to cure. Skin defects can be covered by the scrotal skin flap and free skin graft. The inguinal lymph nodes are not necessarily metastatic to cancer. The resection area is not enough, Invasion of the dermis, adenocarcinoma in the lesion is the main reason for recurrence.