Extramammary Paget’s Disease Manifested by Intraepithelial Adenocarcinoma of the Vulva and Anus Combined with Invasive Adenocarcinoma of the Ampullary Part of the Rectum

The Object of this Study: author the given paper describes an unusual combination two diseases: extramammary Paget’s disease manifested by intraepithelial adenocarcinoma vulva and anus combined with invasive ampullary part rectum atypical manifestations these diseases. Content: content research includes a description patient, analysis clinical picture, diagnostic methods therapeutic interventions used, report following disease, result presented case. Result Research Work: work is case different tumors, where such tumors rarely described in literature. Moreover, no large specific sample diseases available. Patient Characteristics: patient Palliative Care Unit Gerontology Clinic primary diagnosis C20-rectal background anal canal, perineal skin stage IV. complications patient’s are multiple metastases liver; status post palliative chemotherapy; hepatomegaly; to abdominal lymph nodes, inguinal nodes; at Th12, L4 level; pain syndrome. above diagnosed very rare. Applied Diagnostics: In October 2021, it was performed manipulation: biopsy pathologist have provided microscopic description. first tissue fragment had pronounced electrothermal lesion epithelial structures were not valuable. second covered hyperplastic acanthotic epithelium; its basal middle layers contained cells proliferates extending into medial epidermis, cytoplasm reacted positively PAS (Periodic Acid Schiff reaction). It needs be noted that previously several years biopsies from also been diagnosed. immunohistochemistry showed CK20 positive, CK7 rare positive p16 negative. pathohistological findings made: morphological immunohistochemical picture consistent disease. According ICD-10, C51 malignant neoplasm female external genitalia. Using imaging diagnostics, became clear rectal progressed metastatic distant liver Therapeutic Plan Patient: Based on main diagnoses, principal diagnosis, overall severe condition, syndrome, age comorbidities, chemotherapy approved as option council doctors. Monitoring Outcome general condition becoming worse over time, she exitus latalis December 2022. At discharged hospital care home under control her family physician.