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Open Access
CC BY 4.0 · Arch Plast Surg
DOI: 10.1055/a-2706-1145
Case Report

Factors Related to Recurrence Rates of Extramammary Paget Disease: A Case Series and Literature Review

Authors

  • Boonyaporn Kotistienkul 

    1   Division of Plastic Surgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand

  • Nattanit Poungjantaradej 

    1   Division of Plastic Surgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand

  • Natthapong Kongkunnavat 

    1   Division of Plastic Surgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand

  • Warangkana Tonaree 

    1   Division of Plastic Surgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand

Funding Information None.
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Abstract

Extramammary Paget disease (EMPD) is a rare cutaneous malignant lesion. Surgical resection is the primary treatment. However, the ideal surgical margin remains uncertain. This study aimed to investigate the correlation between different margins and EMPD recurrence rates. A total of 35 EMPD patients underwent surgical resection between 2008 and 2018. This study considered multiple factors associated with the local recurrence rate, including surgical margin, depth of excision, pathological margin, tumor size, and the time until recurrence occurred. The study demonstrated that a surgical margin of 2 cm signified the outcome of local recurrence, with 20.8% in the <2 cm group and no local recurrence (0.0%) in the ≥2 cm group (p = 0.157). The tumor size statistics significantly affected the local recurrence at 9 cm (p < 0.05). Other managements had no statistical significance to the local recurrence rate. A surgical margin size of more than 2 cm is suggested for the wide excision of EMPD patients, considering the recurrence percentage and outcome in this study.

This retrospective study aimed to find the relation of surgical margin and the disease outcome of extramammary Paget disease (EMPD) by considering multiple factors associated with the local recurrence rate, including surgical margin, depth of excision, pathological margin, tumor size, and the time until recurrence occurred. The result showed that a surgical margin of ≥2 cm gave a better outcome of disease, and a tumor larger than 9 cm significantly affected the recurrence rate. The study suggests surgical excision of more than 2 cm around the tumor.

Keywords

extramammary Paget disease - surgical margins - pathological margins - local recurrence rates - tumor size

Ethical Approval

This study was approved by the institutional review board (IRB) of Siriraj Hospital under No. 596/2565 COA Si018/2023.


Informed Consent

Written informed consent was obtained from the patient for the publication.




Publication History

Received: 12 January 2025

Accepted: 04 September 2025

Accepted Manuscript online:
22 September 2025

Article published online:
17 January 2026

© 2026. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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