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女阴柏哲氏病(Paget’s Disease)是极为罕见的疾患,国內文献中尚未见报导。国外文献记载亦颇少,该病一般偶见于乳头及乳晕部,而发生在女阴者近年的文献报导约30例左右,兹将我院所见1例报导如下。病例报告女性,64岁,于1959年11月入院,主诉:外阴部溃癌十三年,最近二年加剧。现在史:十三年前外阴郎首先发现一硬结,以后硬结溃烂,且经常流黄水,并伴有搔癢,未经治疗,唯最近半年中溃疡逐(?)扩散,分泌液波增多。曾在某院检查,印象为女阴炎,经一般药物治疗无效。全身检查无异常发现。妇科检查:病变以左侧大小阴唇为主,表面皮肤粗糙,呈结节状增厚及色素沉着,并有大小不等散在性溃疡,其边缘不齐,表面披复浆液性痂,病变蔓延至阴蒂及右侧阴唇(图一),阴道及宫颈呈老年性萎缩,双侧附件正常,子宫体已于二十三年前因子宫肌瘤手术摘除。双侧鼠蹊部淋巴结未见肿大。大阴唇溃疡处活检之病理诊断为女阴柏哲氏病。入院后作外阴广泛性切除术,术后随诊近二年尚未复发。
Paget’s Disease is an extremely rare condition that has not been reported in the domestic literature. Foreign literature records are also quite few, the disease is usually seen in the nipple and areola Department, and occurred in the female genital recent literature reported about 30 cases, we will see 1 case of hospital reported as follows. Case Report Female, 64 years old, admitted to hospital in November 1959, complains: Thirteen years of genitourinary ulcer cancer, exacerbated in the last two years. History now: Thirteen years ago, the vulva first discovered an induration. After induration ulceration, and often flow yellow water, and accompanied by itching, untreated, only the last six months ulcer by (?) Diffusion, increased secretion wave. Have checked in a hospital, the impression of female Yin Yan, the general drug treatment is invalid. No abnormal body check found. Gynecological examination: the lesion to the size of the left side of the labia mainly rough surface of the skin, nodular thickening and pigmentation, and ranging in size scattered ulcers, the edge of the missing surface scrape serous scab, lesions spread to Clitoris and labia minora (Figure 1), the vagina and cervix were age-related atrophy, bilateral attachment normal, uterine body was twenty-three years ago due to uterine fibroids surgery. Bilateral groin lymph nodes no enlargement. Labia ulcer biopsy of the pathological diagnosis of female Yinbaizhe disease. After admission for vulvar extensive excision, postoperative follow-up has not relapsed nearly two years.