Eczematoid carcinoma of vulva, also known as Paget disease of vulva, is a rare malignant tumor of vulva. More common in elderly women over 70 years old, it is a slow and progressive cancer. Eczematoid carcinoma of vulva is a kind of intraepithelial carcinoma, which contains typical Paget cells and vacuoles. About half of the patients have sweat glands involved. It mostly occurs in labia majora and perianal region.

Symptoms:

Vulvar itching and burning sensation are common symptoms. Examination shows that vulvar lesions are higher than skin, with local thickening, induration and desquamation on the skin surface, and hypopigmentation is often similar to leukoplakia. During the consultation, the lesions were superficial. If there is sweat adenocarcinoma under it, there may be thickening and mass formation under the epidermis at the time of consultation.

Check:

1. scattered in the focus, with red particles on the surface, clear edges and white spots in the middle; The surface often festers and sometimes scabs. The diseased skin showed exudative changes like eczema.

2. Microscopic examination showed that 70% of the lesions were in epidermis. Epithelial thickening, echinoderm-like, deep epidermal infiltration of Paget cells. Paget cells are large round cells with transparent cytoplasm or granular cells, large nuclei and few mitotic images. Histologically, Paget cytoplasm contains acidic and neutral mucopolysaccharides, and Asin blue staining is positive. PAS staining was positive before and after amylase treatment. Mucus card red reaction was also positive; Sulfur gold staining showed mucus.

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Diagnosis:

1. mostly occurs before and after menopause and the elderly, and a few are women aged 30-40.

2. Chronic vulvar itching with a long course of disease.

3. It mostly occurs in labia majora and perianal area, showing patchy eczema-like lesions, redness or skin whitening, clear boundaries, and the range of lesions varies, which may be accompanied by local exudation, ulcer, dementia, etc.

4. Histopathological diagnosis showed that Paget cells were the main lesions, which were confined to the epithelial layer and belonged to carcinoma in situ. The diagnosis should be made by continuous biopsy, and the adenocarcinoma of skin adnexa (about 20%) complicated by different treatment schemes should be excluded.