case_images: PMC11250610_01
case_images: a Erythema was widely observed from lower abdomen to perineum. Mapping biopsy revealed lesion in right lower abdomen. Black line indicates resection range. b Histological examination of excised lesion of the genitals. Pagetoid cells with prominent nuclei and brilliant cytoplasm were present diffusely in the epidermis (haematoxylin and eosin (H&E), x200).
case_images: cde-2024-0016-0001-538675_F01.jpg
case_images: PMC11250610_01_cde-2024-0016-0001-538675_F01.jpg
case_images: F1
case_images: After the mapping biopsy, total excision and split-thickness skin grafting were performed, and the margins were negative (shown in Fig. 1).
case_images: Erythema in the lower abdominal, umbilical region, and both axillae. Erythema on the resection margin in the lower abdominal (recurrent) (a), in the umbilical fossa and the scar of the umbilical region (b), right axilla (c), and left axilla (d).
case_images: cde-2024-0016-0001-538675_F02.jpg
case_images: PMC11250610_01_cde-2024-0016-0001-538675_F02.jpg
case_images: F2
case_images: Twelve years after total resection, an erythematous lesion appeared on the resection margin in the lower abdomen (shown in Fig. 2a), and the serum carcinoembryonic antigen (CEA) was 0.9 ng/mL (cut-off <5.0 ng/mL). Similar lesions were observed in the umbilical fossa, the scar in the umbilical region, and both axillae (shown in Fig. 2b-d).
case_images: a Pagetoid cells were present diffusely and focally in the epidermis of the lower abdomen (H&E, x200). b Umbilical lesion showing positively stained Pagetoid cells scattered mostly in basal cell layers (CK 7, x80).
case_images: cde-2024-0016-0001-538675_F03.jpg
case_images: PMC11250610_01_cde-2024-0016-0001-538675_F03.jpg
case_images: F3
case_images: Immunohistochemically, the tumour cells were positive for CEA, gross cystic disease fluid protein -15, cytokeratin (CK) 7, and periodic acid-Schiff staining and negative for CK20, which was the same result as that of total excision performed 12 years ago (shown in Fig. 3).