乳房外柏哲德氏病（Extramammary Paget’s Disease）（EMPD）是一罕見的疾病，好發年紀
在 50 至 80 歲，好發部位在汗腺較發達的地方如肛門周圍、陰囊、會陰與外陰部。臨床症狀很
像乳頭的柏哲德氏病，主要的症狀為搔癢，情況與一般細菌感染相似，很容易被誤診，一開始呈現界限明顯、單一脫屑性表層的紅疹，常被當成慢性濕疹治療，延誤治療的時機，增加癌症細胞轉移的機會，同時會合併有其他鄰近器官的癌症。
治療傳統以外科手術切除，一般來說，預後良好但復發率高。如位在解剖位置複雜的地方如會陰、肛門周圍等處，為要達根除目的，甚至要需要切除肛門，對病人心理與生活上造成很大的影響保守性治療有局部化療、局部免疫調節藥物或放射治療，但都因病例不多，無法有確切的定論。藉由此文報告一位以放射線治療乳房外柏哲德氏病的病例，並回顧有關乳房外柏哲德氏病以放射線治療的文獻，提供大家對此一疾病除手術外另一效果不錯的選擇。
[ 放射治療與腫瘤學2010; 17(4): 317-322 ]

Extramammary Paget’s disease (EMPD) is an uncommon cutaneous adenocarcinoma.
It predominantly involves apocrine gland-bearing areas, especially
the vulva,scrotum, and perianal areas. In contrast to mammary Paget’s disease, extramammary Paget’s disease may or may not be associated with internal malignancy. Initially, the lesion is typically erythematous, dry, and raised with pruritus. It later may turn into an eczematoid, crusted, ulcerated, or papillary lesion with pain and bleeding. Patients
often give a history of prolonged treatment with topical corticosteroid and antifungal agents before a diagnosis is made by biopsy of the lesion. Extramammary Paget’s disease should be highly suspected if a skin lesion fails to clear with topical steroid and antifungal treatment.
Many different treatment modalities have been reported, including surgery or Mohs micrographic surgery, radiotherapy, chemo-radiotherapy, topical chemotherapy and topical immune modulator. The effectiveness of radiotherapy is generally difficult to ascertain because most of the literatures comprised mostly of individual case reports. We report a case of genital EMPD treated with curative intent radiotherapy and to review relevant literatures of treatment modality except surgery as a firstchoice
treatment in anogenital EMPD.
[Therapeut Radiol Oncol 2010; 17(4): 317-322 ]