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KMID : 0358820070340060753
Journal of Korean Society of Plastic and Reconstructive Surgeons
2007 Volume.34 No. 6 p.753 ~ p.758
Resurfacing the Large Penoscrotal Defects with Various Local Flaps after Ablation of Extramammary Paget¡¯s Disease


Kang Nak-Heon
Abstract
Purpose: Penoscrotal extramammary Paget¡¯s disease is a rare cutaneous malignancy that primarily affects the elderly. To prevent local recurrence, adequate surgical excision with its intraoperative frozen section, proper reconstruction, and careful follow-ups are required. The present study describes the treatment of patients with penoscrotal extramammary Paget¡¯s disease, focusing on the reconstruction after the ablation of lesion.

Methods: Nine patients were selected who had undergone a local pedicle flap procedure due to the large defects after ablation of extramammary Paget¡¯s disease of the penoscrotal area, during the period of 1999 to 2005. Wide excision combined with intraoperative frozen sectioning was performed, and the penoscrotal wound was reconstructed with a local skin flap. Three flaps were chosen depending on the size of the defect. If the defect size was small and the scrotal tissue was adequate, scrotal flap(n=5) was enough for its reconstruction. However, as there were large defects with insufficient remnant scrotal tissue, a groin flap(n=2) or an anterolateral thigh flap(n=2) were performed.

Results: There were no complications with the postoperative wound. Furthermore, no local recurrence was noted during two to six years of follow-up period (mean average 3.7 years).

Conclusion: For the resurfacing the penoscrotum at large defects after ablation of extramammary Paget¡¯s disease, we performed reconstruction with a local flap. In the aspect of both function and cosmetic concerns, the results were satisfactory.
KEYWORD
Penoscrotal extramammary Paget¡¯s disease, Scrotal flap, Groin flap, Anterolateral thigh flap
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