# A Case of Secondary Extramammary Paget's Disease Surrounding a Cutaneous Ureterostoma After Recurrence of Bladder Urothelial Carcinoma

## TL;DR

A man developed a rare skin condition called secondary extramammary Paget's disease near a surgical opening after his bladder cancer recurred.

## Contribution

This case report highlights the occurrence of secondary extramammary Paget's disease following recurrence of urothelial carcinoma after urinary diversion.

## Key findings

- A 68-year-old man developed secondary extramammary Paget's disease around a ureterostoma after bladder cancer recurrence.
- Pathology confirmed urothelial carcinoma and pagetoid cells in the epidermis, indicating secondary Paget's disease.
- The case suggests a link between recurrent upper urothelial carcinoma and secondary extramammary Paget's disease.

## Abstract

Secondary extramammary Paget's disease features intraepidermal carcinoma caused by tumor invasion and migration into adjacent skin.

A 68‐year‐old man underwent radical cystectomy and bilateral cutaneous ureterostomy for bladder cancer and right ureteral cancer. Postoperative follow‐up computed tomography and urine cytology at 3 years suggested right ureteral cancer recurrence. Contemporaneous erythema and bulging of the skin around the right ureterocutaneous fistula were observed, necessitating retroperitoneoscopic nephroureterectomy and peristomal skin resection. Pathology revealed urothelial carcinoma with T2 disease at the lower ureter, plus spreading cytokeratin 7+ and cytokeratin 20+ pagetoid cells clustered within the epidermis indicative of secondary Paget's disease.

In cases of recurrent upper urothelial carcinoma after urinary diversion, patients may develop secondary extramammary Paget's disease of the skin.