Case report 403: Extra-mammary Paget disease of the skin with disseminated skeletal metastases

The case is presented of a 64-year-old man who complained on admission of discomfort in the right shoulder at the time of excision of a large section of the axillary skin which contained extra-mammary Paget disease. Shortly thereafter, radiological studies of the humerus and scapula showed obvious malignant disease which proved to be metastatic upon biopsy of the humerus and pathological studies of the excised area of extra-mammary Paget disease in the axillary skin. The patient died twelve months after the diagnosis was established with widespread metastatic disease. The literature on the subject was reviewed and it was demonstrated that metastases to the skeleton from lesions of the skin are relatively rare. This case is exceptional because of the rapid fatal course and the extent of metastatic disease originating in extra-mammary Paget disease of the axillary skin. (orig.)