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目的 报道Mohs显微描记手术联合5-氨基酮戊酸光动力疗法(ALA-PDT)治疗会阴部乳房外Paget病1例。方法 于阴茎前段包皮水肿机化所致瘢痕挛缩狭窄处行“Z皮瓣”成形术,松解瘢痕;Mohs显微描记手术切除阴茎根部及阴囊上部的乳房外Paget病变组织,阴囊皮瓣修复创面;创面愈合拆线后5~7d开始对手术区域及周边范围进行ALA-PDT治疗,10d1次,4次为1个疗程。结果 术后患者创面愈合良好,外观功能无异常,排尿障碍明显改善。术后随访2年,未见肿瘤复发和转移。结论 Mohs显微描记手术是治疗乳房外Paget病的重要手段,ALA-PDT对于彻底清除肿瘤组织和降低复发率有一定作用。
Objective To report 1 case of extramammary Paget’s disease of the perineum by Mohs microscopy combined with 5-aminolevulinic acid photodynamic therapy (ALA-PDT). [Methods] The method of “Z-flap” angioplasty was performed on the scar contracture caused by foreskin edema in the penis. The Mohs microsurgery was performed to remove the extrathoracic Paget lesion and the scrotum flap Repair wounds; wound healing 5 ~ 7d after suture removal of the surgical area and the surrounding area ALA-PDT treatment, 10d1 times, 4 times for a course of treatment. Results After operation, the wound healing of patients was good, appearance and function were normal, and voiding dysfunction was obviously improved. After 2 years of follow-up, no tumor recurrence and metastasis. Conclusion Mohs microsurgery is an important method for the treatment of extramammary Paget’s disease. ALA-PDT may play a role in the complete removal of tumor tissue and the reduction of recurrence rate.